Increased frequency of osteoporosis and BMD below the expected range for age among South Korean women with rheumatoid arthritis
Increased frequency of osteoporosis and BMD below the expected range for age among South Korean women with rheumatoid arthritis
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DOI：
10.1111/j.1756-185x.2012.01729.x
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发表时间：
2012-06-01
影响因子：
2.5
通讯作者：
Baek, Seung-Hoon
中科院分区：
文献类型：
--
作者：
Lee, Seung-Geun;Park, Young-Eun;Baek, Seung-Hoon
目的比较女性类风湿关节炎（RA）患者与健康人骨质疏松和骨密度（BMD）低于预期年龄范围的发生率，探讨女性RA患者骨丢失的危险因素。方法选择299例RA患者和246例健康体检者作为研究对象。采用双能X线骨密度仪测量腰椎、股骨颈和全髋骨密度。绝经后女性T评分为-2.5或更低定义为骨质疏松症，绝经前女性Z评分为-2.0或更低定义为低于预期年龄范围。结果RA患者的骨质疏松发生率（22.1%）明显高于健康对照组（11.4%）（P相似=相似0.014）。RA患者BMD低于预期年龄范围的发生率（7.8%）也显著高于健康受试者（1.0%，P = 0.015）。在299例女性RA患者中，年龄较大、体重指数较低和绝经后状态与腰椎和髋部BMD降低显著相关。在疾病相关变量中，糖皮质激素的使用与髋部BMD的降低独立相关。结论类风湿关节炎患者骨质疏松的患病率是健康人的1.9倍。糖皮质激素的使用是女性类风湿关节炎患者全身性骨丢失的危险因素。
Objective To compare the frequency of osteoporosis and bone mineral density (BMD) below the expected range for age between female patients with rheumatoid arthritis (RA) and healthy subjects and to determine risk factors for bone loss in female patients with RA. Method Two hundred and ninety-nine patients with RA and 246 age-matched healthy subjects were included in this study. BMD in the lumbar spine, femoral neck and total hip were measured with dual-energy X-ray absorptiometry. A T-score of -2.5 or lower in postmenopausal women was defined as osteoporosis, and a Z-score -2.0 or lower in females prior to menopause was defined as below the expected range for age. Result The frequency of osteoporosis in the RA patients (22.1%) was significantly higher than in healthy subjects (11.4%) at either the spine or hip (P similar to=similar to 0.014). The occurrence of BMD below the expected range for age in RA patients (7.8%) was also significantly higher than in healthy subjects (1.0%, P similar to=similar to 0.015). In 299 female patients with RA, higher age, lower body mass index and postmenopausal status were significantly associated with the lumbar spine and hip BMD reduction. Of disease-related variables, glucocorticoid use was independently associated with reduction of hip BMD. Conclusion The prevalence of osteoporosis in the RA patients was 1.9 times higher than in healthy subjects. Glucocorticoid use was a risk factor for generalized bone loss in female RA patients.