Rheumatoid Arthritis Itself a Risk Factor for Osteoporosis in Men

January 4, 2001

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WESTPORT, CT (Reuters Health) Jan 02 - Reduced bone mineral density (BMD) in men

with rheumatoid arthritis (RA) is common, according to a report in the December

issue of the Journal of Rheumatology. Active rheumatoid disease itself appears

to be the most important modifiable risk factor.

Dr. Jane F. Bleasel, of Forster Hospital, Redfern, Australia, and

colleagues collected clinical and demographic data on 50 consecutive men with RA

(mean age 67 years), whose mean disease duration was 20 years. Fourteen men had

never taken oral corticosteroids, while 36 had taken a range of prednisone doses

for a mean of 8.4 years.

According to the report, spinal BMD was reduced in 38% of the men. Femoral neck

BMD was reduced in 71%, and 29% were found to be osteoporotic. According to

measurements at the lumbar spine, 19% were osteopenic and 19% were osteoporotic.

Ten percent of the men had experienced a nontraumatic fracture.

The team notes that 40% of the men had moderately reduced plasma testosterone

concentrations (less than 10 nmol/L), while 6% had severely reduced

concentrations (less than 8 nmol/L). In contrast to some other studies, however,

androgen deficiency was not significantly related to bone density or fractures.

" Although corticosteroid use had a significant effect on spinal BMD,

corticosteroid dose, years of corticosteroid treatment, and cumulative steroid

dose were not significant predictors of spinal or femoral BMD, " Dr. Bleasel's

team reports. " Femoral neck BMD was related to age, weight, disability status,

and specific disease activity scores. The only predictors of spinal BMD were

pack-years of smoking and physician global assessment. "

" The predictors for spine and femoral neck BMD bear little direct relationship

to blood testosterone concentrations despite the relatively high prevalence of

low testosterone concentrations in this population, " the authors conclude.

" These findings are more consistent with the possibility that low testosterone

concentrations in men with RA are a bystander effect of systemic inflammatory

disease. "

J Rheumatol 2000;27:2786-2790.

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