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Ann Rheum Dis. 2007 Nov;66(11):1508-12. Epub 2007 Apr 24.

Bone mineral density in patients with recently diagnosed, active rheumatoid arthritis.

Author information

1
Leiden University Medical Centre, PO Box 9600, 2300 RC, Leiden, The Netherlands. m.yuksel@lumc.nl

Abstract

OBJECTIVES:

Osteoporosis is a well-known extra-articular phenomenon in patients with uncontrolled, long-standing rheumatoid arthritis (RA). In the present study, the extent of osteoporosis and reduced bone mineral density (BMD) and the disease-related and demographic factors that are associated with osteoporosis and reduced BMD were examined in patients with recently diagnosed, active RA.

METHODS:

BMD of the total hip and the lumbar spine was measured using dual-energy x ray absorptiometry in 381 patients with recently diagnosed active RA, who had never been treated with DMARDs or corticosteroids. Osteoporosis was defined as a T score <or=-2.5 SD and reduced BMD as Z score <or=-1 SD. Multivariate logistic regression analyses were performed to detect associations of osteoporosis and reduced BMD with disease activity, functional disability, joint damage (Sharp-van der Heijde score) and demographic factors.

RESULTS:

Osteoporosis and reduced BMD were found in the spine and/or the hip in 11% and 25%, respectively, of the patients. Longer symptom duration and presence of rheumatoid factor (RF) were the only RA-specific markers for osteoporosis and reduced BMD. Further, postmenopausal status in women, a low body mass index, familial osteoporosis, and, remarkably, male gender, were independently associated with osteoporosis and reduced BMD.

CONCLUSION:

In patients with recently diagnosed active RA who had never been treated with DMARDs or corticosteroids, BMD seems to be well-preserved and predominantly related to demographic factors. Longer symptom duration and a positive RF, but not higher disease activity or more joint damage, were related to osteoporosis and reduced BMD.

PMID:
17456523
PMCID:
PMC2111640
DOI:
10.1136/ard.2007.070839
[Indexed for MEDLINE]
Free PMC Article
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