An epidemiological analysis of osteoporotic characteristics in patients affected with rheumatoid arthritis in Kazakhstan
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We aimed to assess which of the major risk factors associated with rheumatoid arthritis (RA) severity are also associated with osteoporosis-related phenotypes (OP-RP) in the native population of Kazakhstan.
Four hundred six RA patients (90.6% females) with 397 controls—unaffected first-degree relatives were recruited. Biochemical factors were recorded, and OP-RP were assessed using QCT scans and ultrasound densitometry (US) of the forearm to estimate cortical indices (CI), spongial bone mineral density (BMDSPN), and US_T-scores.
In the RA affected female population, ~ 80% suffered from osteopenia or osteoporosis. All OP-RP were negatively correlated with age and female’s sex, as expected, and thus accordingly adjusted, resulting in consistent, significantly [p = 0.016 (CI), p < 0.0001 (both BMDSPN and US_T-scores)] lower OP-RP estimates in affected females. Using multiple regression analysis for OP-RP manifestations, only age and disease duration appeared consistently associated with all three studied phenotypes, while menopause status or years following the onset of menopause were also significant for BMDSPN and US_T-scores. However, when disease duration was examined, we found that it was significantly dependent on morning stiffness, ESR, total cholesterol levels, weight, and menopause status, which explains 38.6% of the disease duration.
Approximately 80% of female RA patients suffer from osteoporosis or osteopenia in the study group, which appears from a young age. RA disease duration is the major risk factor for OP-RP deterioration, especially as assessed by BMDSPNG, and US_T-scores. As a result, all OP-RP demonstrate significantly lower levels in comparison to sex- and age-matched unaffected individuals.
KeywordsRheumatoid arthritis Bone mineral density (BMD) Cortical index US_T-score Osteoporosis Risk factors
Anti-citrullinated protein antibody
Bone mineral density of the medullar compartment of ulna
Body mass index
Bone cortical index
Averaged cortical index of ulna and radius
Erythrocyte sedimentation rate
Blood glucose levels
High density lipoprotein
Systolic blood pressure/diastolic blood pressure
Ultrasound T-criterion (US TC)
Ultrasound Z-criterion (US ZC)
Waist hip ratio
The study was supported by Kazakhstan Ministry of Education and Science (grant № 2460/ГФ4, registration number 0115РК00901)
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