More than half of women with rheumatoid arthritis in a recent study had low vertebral trabecular bone quality, with older age and type 2 diabetes identified as significant risk factors.
In a cross-sectional study of 203 women with rheumatoid arthritis (RA) published in the Journal of Clinical Medicine, researchers led by Jose Jorge Gomez-Camarena, MD, of Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, found that 52% had a trabecular bone score (TBS) of 1.300 or less, indicating low bone quality. The mean TBS for the cohort was 1.301. Bone quality was measured using TBS derived from dual X-ray absorptiometry (DXA) scans of lumbar vertebrae L1 to L4.
Participants had a mean age of 59 years and a mean RA duration of nearly 14 years. Most were postmenopausal (83%), and 72% were receiving corticosteroids. The mean daily corticosteroid dose was 4.3 mg, with a mean duration of 5.8 years and a cumulative dose of 35.6 g.
Compared with patients who had normal TBS, those with low TBS were older (62 vs 56 years) and more likely to have diabetes (13% vs 4%), menopause (90% vs 75%), and hypertension (50% vs 34%). Lumbar bone mineral density was lower in the low TBS group (1.77 vs 1.86 g/cm²), and osteoporosis was more prevalent (52% vs 22%;).
No statistically significant associations were found between corticosteroid use and TBS. Rates of corticosteroid use were similar between low and normal TBS groups (70% vs 75%), as were daily dose (4 vs 4.6 mg/day), duration of use (5.4 vs 6.4 years), and cumulative dose (31.2 vs 40.4 g).
In multivariate logistic regression, each additional year of age increased the odds of low TBS by 5%, and the presence of type 2 diabetes was associated with more than threefold increased odds. No associations were found between low TBS and disease activity, functional disability, or RA duration. Other factors, including body mass index and smoking, were not significant in adjusted models.
All participants met the 1987 American College of Rheumatology classification criteria for RA. Patients with conditions or treatments known to affect bone metabolism were excluded.
The authors reported no conflicts of interest.
Source: Journal of Clinical Medicine
