The frequency of and risk factors for osteoporosis in Korean patients with rheumatoid arthritis

Lee, Juhyun; Sung, Yoon Kyoung; Choi, Chan Bum; Cho, Soo Kyung; Bang, So Young; Choe, Jung Yoon; Hong, Seung Jae; Jun, Jae Bum; Kim, So Yeon; Lee, Sang Hoon; Lee, Hye Soon; Yoo, Dae Hyun; Yoon, Bo Young; Bae, Sang Cheol

doi:10.1186/s12891-016-0952-8

Cited by 42 publications

(45 citation statements)

References 25 publications

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“…Conventional risk factors for osteoporosis in RA include the use of glucocorticoids, longer disease duration, high disability scores, low body weight and age [24]. Our data seem to favour this possibility, and the factors which appeared to have the most predictive value were disease duration, inflammatory state and severity of the disease process.…”

Section: Discussionsupporting

confidence: 49%

Osteoporotic Fracture Risk in Rheumatoid Arthritis

Syngle¹,

Kaur²,

Garg

2018

Int J Pharm Pharm Sci

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Objective: Osteoporosis is an extra-articular complication of rheumatoid arthritis (RA) with increased risk of fractures. FRAX is an online tool for assessing risk of osteoporotic fracture. However, the relationship between the FRAX score and disease specific risk factors has not yet been investigated in RA. Hence, we assessed 10-year fracture risk using FRAX and its relationship with disease activity score, inflammation and disease duration in RA.Methods: 50 RA patients enrolled and recruited consecutively in a special camp organized for RA patients on the occasion of World Osteoporosis Day, 2016to estimate the osteoporotic fracture risk from Rheumatology clinic. Predicted 10-year risk of hip fracture and major osteoporotic fracture (MOF) by FRAX score without information on bone mineral density (BMD). Inflammatory disease activity measures included disease activity score of 28 joints (DAS28), erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were also measured. FRAX score also estimated in 40 age and sex matched healthy controls.Results: FRAX estimated significantly enhanced fracture risk in active RA, both for MOF (13.34±1.26%) and hip fracture (6.84±1.03%) as compared to controls for MOF (5.46±0.95%) and hip fracture (1.97±0.49%). In RA patients, MOF and hip fracture risk correlated with DAS28 and disease duration and MOF risk correlated with ESR and CRP. Conclusion:Active RA patients, even in the absence of BMD have an increased FRAX score indicating an enhanced 10-year probability of MOF and hip fracture. Long disease duration, high disease activity and an elevated ESR and CRP are potential disease specific risk factors for osteoporotic fractures in RA.

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Section: Discussionsupporting

confidence: 49%

Osteoporotic Fracture Risk in Rheumatoid Arthritis

Syngle¹,

Kaur²,

Garg

2018

Int J Pharm Pharm Sci

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“…[38] Moreover, in a Korean cohort study, a large percentage (90.8%) of rheumatoid arthritis patients had osteoporosis and osteopenia. [39] Moreover, due to steroid use, patients with rheumatoid arthritis were more prone to secondary osteoporosis. [29] Ioannidis et al conducted a 10-year prospective observational cohort study including 9263 ambulatory men and women, and their results showed that glucocorticoid treatment was associated with an increased 10-year incidence of fracture risk [HR for nonvertebral fracture 1.5, 95% CI 1.1–2.0, prior glucocorticoid treatment vs never glucocorticosteroid (GC) treatment].…”

Section: Discussionmentioning

confidence: 99%

Increased risk of vertebral fracture in patients with rheumatoid arthritis

Chen¹,

Cheng²,

Wang³

et al. 2016

Medicine

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The relationship between rheumatoid arthritis and risk of vertebral fracture has been reported by several observational studies. However, there is no higher-level evidence study, such as meta-analysis, that has investigated the relationship, and its mechanisms are not yet fully clear. This meta-analysis aimed to provide a summary of an observational study of the relationship between rheumatoid arthritis and the risk of vertebral fractures.Relevant studies were identified by searching PubMed and EMBASE databases (up to August 1, 2016). We included published observational studies (cohort or case-control design) evaluating the relationship between rheumatoid arthritis and the risk of vertebral fractures. Two reviewers searched and abstracted the data independently. Relative risks (RRs) with 95% confidence intervals (CIs) were used throughout the whole analysis.Seven observational studies (2 cohort studies, 2 nested case-control studies, and 3 case-control studies) were included in this meta-analysis. The results showed that the pooled RR of vertebral fracture for individuals with rheumatoid arthritis was 2.34 (95% CI 2.05–2.63, I2 = 35.4%, P for heterogeneity = 0.16). Further subgroup analysis by sex showed that the pooled RRs for both women and men, and only women were 2.14 (95% CI 1.47–2.8, I2 = 48.5%, P for heterogeneity = 0.12) and 2.39 (95% CI 2.07–2.70, I2 = 34%, P for heterogeneity = 0.22), respectively. Subgroup analysis by study design showed that the pooled RRs for cohort studies, nested case-control studies, and case-control studies were 2.31 (95% CI 1.95–2.67, I2 = 4.8%, P for heterogeneity = 0.31), 1.89 (95% CI 1.01–2.77, I2 = 72.1%, P for heterogeneity = 0.06), and 2.62 (95% CI 2.04–3.91, I2 = 26.1%, P for heterogeneity = 0.26), respectively.Based on our meta-analysis, rheumatoid arthritis should be regarded as an independent risk factor of vertebral fracture. Further studies are needed to institute prevention and treatment strategies.

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“…However, the results are often presented in the form of one specific disease type comparing with RA and healthy subjects, such as rheumatoid arthritis (RA), systemic lupus erythematosus (SLE) and systemic sclerosis (SSc), instead of as a general rheumatic population. In 2016, a cross-sectional study in the South Korean reported the frequency of OP in the RA population was 46.8% 25 . In 2017, a Canada retrospective study revealed the occurrence of 'score lower than expected range for age', osteopenia and OP among 286 patients with SLE was 17.3%, 12.3% and 43.2%, respectively 23 .…”

Section: Introductionmentioning

confidence: 99%

Prevalence and risk factors for bone loss in Southern Chinese with rheumatic diseases

Yang

et al. 2020

Preprint

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Abstract Objectives: This study was to explore the prevalence of different severities of bone loss and the potential risk factors in rheumatic patients. Method: An analytical cross-sectional study design was performed. For the present study, 1,398 rheumatic patients and 302 healthy subjects were recruited and further accepted for data collection and blood and bone mineral density tests. Risk factors for bone loss in rheumatic patients were further analyzed by using multivariate logistic regression analysis. Results: (1) Rheumatic patients in this study are consisted of 40.0% rheumatoid arthritis, 14.7% systemic lupus erythematosus, 14.2% osteoarthritis, 9.2% ankylosing spondylosis, 7.9% gout, 7.0% primary Sjogren syndrome, 3.8% systemic sclerosis, and 3.2% mixed connective tissue disease. (2) In male patients aged under 50 and premenopausal female patients, the bone mineral density score of patients is lower than the healthy persons with the same gender and age (34.3% vs 18.2%， P =0.045). (3) Osteopenia and osteoporosis are more prevailing in male patients aged or older than 50 and postmenopausal female patients than healthy counterparts (92.7% vs 87.2%, P =0.017). (4) Regression analysis indicated that compared with a healthy population, those with systemic lupus erythematosus, rheumatoid arthritis and ankylosing spondylosis gained the highest odd ratio of ‘score below the expected range for age’, osteopenia and osteoporosis, respectively. (5) Hypovitaminosis D, ‘CRP elevated’ was commonly-associated with impaired bone mineral density in all rheumatic patients. Conclusion: Bone loss commonly occurs at any age in the setting of rheumatic diseases. Hypovitaminosis D, elevated CRP was probably commonly-associated with impaired BMD in all age groups of rheumatic patients.

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The frequency of and risk factors for osteoporosis in Korean patients with rheumatoid arthritis

Cited by 42 publications

References 25 publications

Osteoporotic Fracture Risk in Rheumatoid Arthritis

Osteoporotic Fracture Risk in Rheumatoid Arthritis

Increased risk of vertebral fracture in patients with rheumatoid arthritis

Prevalence and risk factors for bone loss in Southern Chinese with rheumatic diseases

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