Abstract
BackgroudThis study is to explore the prevalence of different stages of bone loss and the potential risk factors in rheumatic patients.MethodA cross-sectional study recruits 1398 rheumatic patients and 302 healthy subjects. Demographic data, blood, and bone mineral density (BMD) tests are collected. Risk factors for bone loss in rheumatic patients are analyzed by logistic regression.Results(1) Rheumatic patients are consisted of 40.0% rheumatoid arthritis (RA), 14.7% systemic lupus erythematosus (SLE), 14.2% osteoarthritis (OA), 9.2% ankylosing spondylosis (AS), 7.9% gout, 7.0% primary Sjogren syndrome (pSS), 3.8% systemic sclerosis (SSc), and 3.2% mixed connective tissue disease (MCTD). (2) In male patients aged under 50 and premenopausal female patients, the bone mineral density score of AS (53.9%, P < 0.001) and SLE (39.6%, P = 0.034) patients is lower than the healthy controls (18.2%). (3) Osteopenia and osteoporosis are more prevailing in male patients aged or older than 50 and postmenopausal female patients with RA (P < 0.001), OA (P = 0.02) and SLE (P = 0.011) than healthy counterparts. (4) Those with SLE, RA and AS gain the highest odd ratio of ‘score below the expected range for age’, osteopenia and osteoporosis, respectively. (5) Age, female, low BMI and hypovitaminosis D are found negatively associated with bone loss. Dyslipidemia and hyperuricemia could be protective factors.ConclusionYoung patients with AS and SLE have a significant higher occurrence of bone loss, and older patients with RA, OA and SLE had higher prevalence than healthy counterparts. SLE, RA, SSc and AS were founded significant higher risks to develop into bone loss after adjustment. Age, BMI and gender were commonly-associated with bone loss in all age-stratified rheumatic patients. These findings were not markedly different from those of previous studies.
Highlights
Osteoporosis (OP) is a skeletal disease that refers to the reduction of bone mass and the deterioration of microstructure of bone tissue and leads to an increased risk of bone fragility and fracture and disability and mortality
Results: (1) Rheumatic patients are consisted of 40.0% rheumatoid arthritis (RA), 14.7% systemic lupus erythematosus (SLE), 14.2% osteoarthritis (OA), 9.2% ankylosing spondylosis (AS), 7.9% gout, 7.0% primary Sjogren syndrome, 3.8% systemic sclerosis (SSc), and 3.2% mixed connective tissue disease (MCTD). (2) In male patients aged under 50 and premenopausal female patients, the bone mineral density score of AS (53.9%, P < 0.001) and SLE (39.6%, P = 0.034) patients is lower than the healthy controls (18.2%). (3) Osteopenia and osteoporosis are more prevailing in male patients aged or older than 50 and postmenopausal female patients with RA (P < 0.001), OA (P = 0.02) and SLE (P = 0.011) than healthy counterparts
SLE, RA, SSc and AS were founded significant higher risks to develop into bone loss after adjustment
Summary
Osteoporosis (OP) is a skeletal disease that refers to the reduction of bone mass and the deterioration of microstructure of bone tissue and leads to an increased risk of bone fragility and fracture and disability and mortality. Low body mass index (BMI, kg/m2), female. Hu et al BMC Musculoskeletal Disorders (2020) 21:416. Disease activities would inhibit intestinal calcium and vitamin D absorption. Chronic, systemic, or local inflammation and/or exposure to GC treatment cause an imbalance between bone formation and bone resorption [22] and which are both important determinants of bone loss in RD. Rheumatic patients are more likely to suffer from osteoporosis. More factors need to be included to explore the association. Alcohol intaking, and medical history (e.g. diabetes, hypertension, dyslipidemia, and hyperuricemia) may play a role in the decreased bone mineral density (BMD)
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