Age and gender features of bone mineral density in patients with rheumatoid arthritis
- State Institution «National Science Center «Institute of Cardiology the name of academician M.D. Strazheskaya» NAMS of Ukraine», Kyiv
Summary. Aim — assessment of bone mineral density (BMD) in male and female patients with rheumatoid arthritis (RA) depending on the clinical characteristics. Object and methods. The study was performed on 145 RA patients aged 18–72 years: 117 women (mean age 45.4±13.0 years, average disease duration 9.1±7.7 years, 48 (41.0%) in postmenopausal period — PMP) and 28 men (mean age 46.4±16.9 years, average disease duration 4.2±4.1 years). 91.7% of patients had moderate or high DAS28 RA activity. 68.4% of women and 64.3% of men used glucocorticoid in prednisone equivalent dose ≥5 and ≤10 mg/day for >3 months, 87% of patients used methotrexate. BMD was studied in areas: hip, lumbar spine, forearm (midle part, distal part, ultradistal part). Depending on the stages of the study, patients were divided on groups and correlations between BMD and duration of RA, age of manifestation, disease activity and seropositivity were analised. Results. The number of PMP patients with decreased BMD (osteoporosis and osteopenia) was twice as much as in patients of reproductive age (87.5 and 37.7%, respectively). In PMP, it was found correlation between decreased BMD and duration, activity of the disease. On PMP women BMD decreased in the lumbar spine (L1–L4) after two years of disease, and in the hip (femur neck, total hip) after 10 years of disease. In the reproductive period, a significant reduction in the BMD was detected only in the forearm region (midle part — Z=2.50; p=0.01) and distal part — Z=2.01; p=0.04)) in patients with positive rheumatoid factor, and no changes in BMD depending on duration and activity of the disease. A positive correlation was fined between the age of onset of the disease and the BMD in the forearm. Men with RA after two years of the disease had decreased BMD in all studied areas. In the L1–L4 region the negative correlation with RA activity was detected.
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