Rheumatoid arthritis and risk factors for low bone mineral density

Objective

To study the influence of gender, menopausal status, smoking, previous nonvertebral fractures, hormone replacement use, disease duration and glucorticoid use for low bone mineral density (BMD) in rheumatoid arthritis patients.

Method

A cross-sectional study in 177 patients (164 females and 13 males). BMD was assessed in the spine and femoral neck in a DXA Norland XR26. Low BMD was defined as Z score < -1 compared with our normal population. Student's t test, logistic regression, stepwise logistic regression and multiple logistic regression were calculated.

Results

See Tables 1 and 2 overleaf.

Table 1 Risk factors for low bone mineral density (BMD) in the age-adjusted and sex-adjusted model

Table 2 Multivariable analysis of risk factors for low bone mineral density (BMD)

Conclusions

When risk factors for low BMD were analyzed in an age-adjusted and sex-adjusted model, disease duration and glucorticoid use appeared as significant risk factors for low BMD. In a multivariate analysis, disease duration longer than 5 years appears as independently significant for low femoral neck BMD. Related to glucorticoid use, only more than 10 g cummulative dose was independently significant for low BMD both in the spine and femoral neck.