Osteoporosis Pathophysiology, Epidemiology, and Screening in Rheumatoid Arthritis
Osteoporosis Pathophysiology, Epidemiology, and Screening in Rheumatoid Arthritis
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DOI：
10.1007/s11926-019-0836-7
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发表时间：
2019-07-01
影响因子：
5
通讯作者：
Saag, Kenneth G.
中科院分区：
文献类型：
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作者：
Adami, Giovanni;Saag, Kenneth G.
综述骨质疏松症（OP）在类风湿关节炎（RA）中的负担，并描述在类风湿关节炎（RA）中应用的骨质疏松症筛查策略。RA是一种易发生OP的炎症性疾病，RA中OP的发病机制是多因素的，全身性炎症和糖皮质激素的使用起主要作用。较新的研究报道了类风湿性关节炎自身抗体与OP发展之间的有趣关联。类风湿性关节炎患者的OP筛查策略包括临床和维生素D评估、骨重塑的生化标志物和骨成像评估，特别是双能x线吸收仪（DXA）。脆性骨折是类风湿性关节炎的重要合并症。OP筛查策略在RA患者中既可行又有效，被大多数专科机构推荐。鉴于与OP发展相关的因素（如促炎细胞因子和糖皮质激素治疗）的大量暴露，应特别注意RA患者的生化和DXA结果。
Purpose of ReviewTo review the burden of osteoporosis (OP) in rheumatoid arthritis (RA) and to describe the OP screening strategies applied in RA.Recent FindingsRA is an inflammatory condition that predisposes patients to development of OP. OP in RA has a multifactorial pathogenesis with systemic inflammation and glucocorticoid use playing major roles. Newer studies have reported an intriguing association between RA autoantibodies and the development of OP. OP screening strategies in RA patients include clinical and vitamin D assessment, biochemical markers of bone remodeling, and bone imaging evaluations, particularly dual-energy X-ray absorptiometry (DXA).SummaryFragility fractures are an important comorbidity of RA. OP screening strategies are both feasible and effective in RA patients and recommended by most specialty organizations. Given the considerable exposure to factors related to OP development, such as pro-inflammatory cytokines and glucocorticoid treatment, special attention should be directed to biochemical and DXA results in RA patients.