Volume 6 Supplement 3

Global Arthritis Research Network (GARN): 4th World Congress on Arthritis in Montreal

Open Access

Rheumatoid arthritis and risk factors for low bone mineral density

  • R Arinoviche1
Arthritis Res Ther20046(Suppl 3):89

https://doi.org/10.1186/ar1424

Published: 13 September 2004

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

Variable

Comparison

Spine, odds ratio (95% confidence interval)

P

Femoral neck, odds ratio (95% confidence interval)

P

Female

Male

1.43 (0.44–4.68)

0.55

1.35 (0.41–4.47)

0.63

Menopause

Premenopause

0.96 (0.51–1.81)

0.92

1.34 (0.72–2.52)

0.49

Ever smoking

Never smoked

0.88 (0.42–1.89)

0.76

1.19 (0.57–2.51)

0.64

Nonvertebral

     

   Fracture

No fracture

0.98 (0.28–3.39)

0.98

1.38 (0.42–4.53)

0.59

   Ever HRT

Never HRT

0.41 (0.15–1.15)

0.09

0.30 (0.14–1.10)

0.08

Disease duration

     

   1–5 years

< 1 year

1.51 (0.55–4.06)

0.42

3.07 (0.91–10.34)

0.07

   5 years

< 1 year

2.54 (1.06–6.05)

0.04

7.46 (2.47–22.48)

0.0001

Corticosteroids

     

   Ever

Never

3.19 (1.56–6.54)

0.001

2.07 (1.06–4.02)

0.03

   < 7.5 mg daily

Never

2.75 (1.28–5.88)

0.009

1.83 (0.89–3.74)

0.09

   7.5 mg daily

Never

4.29 (1.81–10.20)

0.001

2.61 (1.15–5.91)

0.02

   < 5 g cummulative

Never

1.51 (0.56–3.99)

0.42

1.04 (0.41–2.67)

0.93

   5–10 g cummulative

Never

2.61 (0.99–6.88)

0.05

0.95 (0.34–2.63)

0.92

   > 10 g cummulative

Never

5.11 (2.3–11.29

0.0001

4.05 (1.9–8.61)

0.0001

Low BMD, Z score < -1 compared with our normal population. HRT, hormone replacement therapy.

Table 2

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

Variable

Comparison

Spine, odds ratio (95% confidence interval)

P

Femoral neck, odds ratio (95% confidence interval)

P

Menopause

Premenopause

0.85 (0.42–1.74)

0.66

1.08 (0.52–2.52)

0.83

Ever HRT

Never HRT

0.69 (0.22–2.16)

0.53

0.55 (0.17–1.76)

0.31

Disease duration

     

   1–5 years

< 1 year

0.95 (0.30–3.07)

0.94

2.31 (0.63–8.52)

0.21

   5 years

< 1 year

1.22 (0.41–3.62)

0.72

4.83 (1.44–16.21)

0.01

Corticosteroids

     

   Never

Ever

0.87 (0.38–2.03)

0.75

0.69 (0.21–2.23)

0.54

   < 5 g cummulative

Never

1.35 (0.37–4.89)

0.65

1.62 (0.45–5.89)

0.46

   >10 g cummulative

Never

5.39 (1.95–14.86)

0.0001

3.73 (1.23–11.26)

0.02

Low BMD, Z score < -1 compared with our normal population. HRT, hormone replacement therapy.

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.

Authors’ Affiliations

(1)
Clìnica de Reumatologia y Rehabilitaciòn

Copyright

© The Author(s) 2004

Advertisement