Self reported non-vertebral fractures in rheumatoid arthritis and population based controls: incidence and relationship with bone mineral density and clinical variables
Self reported non-vertebral fractures in rheumatoid arthritis and population based controls: incidence and relationship with bone mineral density and clinical variables
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DOI：
10.1136/ard.2003.005850
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发表时间：
2004-02-01
影响因子：
27.4
通讯作者：
Kvien, TK
中科院分区：
文献类型：
--
作者：
Orstavik, RE;Haugeberg, G;Kvien, TK
目的：比较女性 RA 患者和对照组受试者在 RA 诊断后自我报告的非椎体骨折的发生率，并探讨非椎体骨折与骨密度 (BMD)、疾病和人口因素之间可能的关联。方法：从县登记的 RA 患者和人口对照 (n=249) 中随机选择 249 名女性 (平均年龄 63.0 岁)，在年龄匹配后随机选择， 对性别、居住区域进行了研究。既往非椎骨骨折的数据从详细的问卷中获得，并测量了髋部和脊柱的 BMD。结果：53 名 RA 患者 (21.3%) 在 RA 诊断后有 67 处骨折，对照的相应数字为 50 (20.1%) 和 60（整体骨折史的配对变量的比值比 (OR) 1.09，95% CI 0.67 至 1.77）。每 100 名患者年的总体骨折率分别为 1.62 和 1.45，但 RA 患者自我报告的髋部骨折有所增加（10 v 2，OR 9.0，95% CI 1.2 至 394.5）。与无骨折史的患者相比，有阳性骨折史的患者病程较长，更有可能出现至少一个关节变形，并且年龄和体重调整后的 BMD 较低。在逻辑回归分析中，骨折史仅与 BMD 独立相关。结论：除了髋部骨折可能例外，非椎骨骨折似乎并不是 RA 的重大负担。在 RA 患者和基于人群的对照中也发现了 BMD 水平和骨折史之间类似的独立关系。
Objective: To compare the incidence of self reported non-vertebral fractures after RA diagnosis between female patients with RA and control subjects, and to explore possible associations between non-vertebral fractures and bone mineral density (BMD), disease, and demographic factors.Methods: 249 women (mean age 63.0 years) recruited from a county register of patients with RA and population controls (n=249) randomly selected after matching for age, sex, and residential area were studied. Data on previous non-vertebral fractures were obtained from a detailed questionnaire, and BMD was measured at the hip and spine.Results: 53 (21.3%) patients with RA had had 67 fractures after RA diagnosis, the corresponding numbers for controls were 50 (20.1%) and 60 (odds ratio (OR) for paired variables for overall fracture history 1.09, 95% CI 0.67 to 1.77). The overall fracture rates per 100 patient-years were 1.62 and 1.45, respectively, but self reported hip fractures were increased in RA (10 v 2, OR 9.0, 95% CI 1.2 to 394.5). Patients with a positive fracture history had longer disease duration, were more likely to have at least one deformed joint, and had lower age and weight adjusted BMD than those with no fracture history. In logistic regression analysis, fracture history was independently related to BMD only.Conclusions: With the probable exception of hip fractures, non-vertebral fractures do not seem to be a substantial burden in RA. Similar independent relationships between levels of BMD and fracture history were found in patients with RA and in population based controls.