RESEARCH - RA: Evidence for Bone Loss in Premenopausal Women

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Journal of Rheumatology

June 2005

Rheumatoid Arthritis: Evidence for Bone Loss in Premenopausal Women

TATIANA FREITAS TOURINHO, AÍRTON STEIN, JOSÉ A.S. CASTRO, and JOÃO C.T.

BRENOL

ABSTRACT.

Objective. To assess bone mineral density (BMD) status in patients with

rheumatoid arthritis (RA).

Methods. Rheumatoid factor-positive premenopausal women with RA meeting the

American College of Rheumatology criteria were enrolled. Exclusion criteria

included diseases or drugs that affect BMD, except for glucocorticoids, and

smoking. Evaluation consisted of a questionnaire, physical examination, and

laboratory tests. Lumbar spine and right proximal femur BMD were measured

with a DPX-Lunar DEXA scanner. Data were analyzed by Student t test,

chi-square, and multivariate analysis.

Results. We studied 78 patients with RA and 39 controls; 82% were Caucasian,

with mean age 35.5 ± 6.7 years, and mean disease duration 48 ± 51 months.

Among patients, 74.4% had been treated with glucocorticoids, with a mean

daily dose of 9.7 ± 5.9 mg. Mean lumbar spine BMD was 1.157 ± 0.124 g/cm2 in

the RA patients, and 1.223 ± 0.147 g/cm2 in controls (p < 0.01). Mean right

proximal femur BMD did not differ significantly. Lumbar spine osteopenia

correlated with " no physical activity at work " status, low body weight, and

duration of glucocorticoid therapy. Femoral neck osteopenia correlated with

" no physical activity at work " status, Steinbrocker class III, erosions of

the hands, and high erythrocyte sedimentation rate (ESR). Trochanteric

osteopenia correlated with " no physical activity at work " status, erosions

on hand radiographs, low body weight, high ESR, and anemia.

Conclusion. Patients with RA of relatively short disease duration already

exhibited significantly lower lumbar spine BMD. The identification of

prognostic markers for bone loss in patients with RA should not only prompt

early therapeutic intervention, but also facilitate early preventive

measures. (J Rheumatol 2005;32:1020-5)

http://www.jrheum.com/abstracts/abstracts05/1020.html

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