RESEARCH - Hand BMD is associated with both total hip and lumbar spine BMD in post-menopausal women with RA

[Guest guest]

Rheumatology Advance Access published online on December 21, 2009

Rheumatology, doi:10.1093/rheumatology/kep385

Hand bone mineral density is associated with both total hip and lumbar

spine bone mineral density in post-menopausal women with RA

Sonali P. Desai1, Ellen M. Gravallese2, A. Shadick1, a

Glass1, Jing Cui1, Frits1, Lori B. Chibnik1, Maher1,

E. Weinblatt1 and H. 1

1Brigham and Women's Hospital, Division of Rheumatology, Immunology

and Allergy, Boston and 2Division of Rheumatology, University of

Massachusetts Medical School, Worcester, MA, USA.

Abstract

Objective. RA is associated with localized bone loss in the hands, as

well as generalized osteoporosis. We evaluated the relationship

between hand digital X-ray radiogrammetry BMD (DXR-BMD) and total hip

and lumbar spine BMD.

Methods. We conducted a cross-sectional study of 138 post-menopausal

women with RA. The DXR-BMD was calculated based on digitized hand

radiographs. Measurements of the total hip and lumbar spine BMD were

performed by a DXA-BMD (BMDa) scan. Patient and physician

questionnaires and laboratory samples supplied information on relevant

covariates. Separate multivariate linear regression models were

constructed to determine the cross-sectional relationship between hand

DXR-BMD (independent variable) and total hip or lumbar spine BMD

(dependent variables).

Results. The cohort comprised women with a median age of 61 years and

RA disease duration of 13 years. Seventy-six per cent were either RF

and/or anti-cyclic citrullinated peptide (anti-CCP) positive and most

had moderate disease activity [median disease activity score-28 joint

count (DAS28) 3.7]. Hand DXR-BMD was significantly associated with

total hip BMD (β = 0.61; P < 0.0001) and lumbar spine BMD (β = 0.62; P

< 0.0008) in adjusted models.

Conclusions. This study suggests that hand DXR-BMD is associated with

both the total hip and lumbar spine BMD among post-menopausal women

with RA. The relationship between bone loss in the hands and

generalized osteoporosis should be further explored in longitudinal

studies of patients with RA.

http://rheumatology.oxfordjournals.org/cgi/content/abstract/kep385v1?papetoc

Not an MD