Risk factors for osteoporosis in patients with rheumatoid arthritis

Abstract

Bacround and aim: Osteoporosis (OP) is considered an extraarticular manifestation of rheumatoid arthritis (RA). The aim of this paper is to study the osteoporosis' prevalence in patients with RA and to reveal the correlations between OP and some clinical, paraclinical and therapeutic variables. Methods: One hundred and twenty-nine menopausal patients with RA, belonging to two departments of rheumatology, were included in the study. Bone mineral density was assessed by dual X ray osteodensitometry at lumbar and femoral level (femoral neck, entire femur). The obtained data were analyzed using bivariate analyses and logistic regression. Results: Medium age was 62.74±7.54 years. Medium BMI was 27,78±4,37 kg/m2, duration of menopause was 16,40± 8,18 years. Forty four percent of the patients had OP. Prevalence of OP increases with RA stage: 24 % in IInd stage, 54% in IIIrd stage and 74% in the IVth stage. Fragility fractures were present in 33% of patients, most of them at spinal level (14%). Forty four percent of the patients received methotrexate, 35% received (in the last 12 months) prednisone and 58% of patients ever received treatment with prednisone. Independent risk factors for osteoporosis are: age, rural environment, weight, BMI, menopause's duration, presence of rheumatoid factor (RF), HAQ score, ESR and CRP. Steroids utilization (currently or ever) represent an independent risk factor for OP. Conclusions: OP is frequent in patients with RA, the risk factors are common with the postmenopausal OP but some RA dependent factors are also involved. Copyright © 2011 Celsius.