Summary
Total body bone mineral (TBBM) measured by dual photon absorptiometry and local bone mineral (BMC) measured by single photon absorptiometry were determined in 55 patients with definite or classical rheumatoid arthritis. All of them had been on a steady dose of anti-inflammatory drugs for at least 12 months, and furthermore, 13 patients were on glucocorticoids. The results were compared with 49 normal persons matched for sex, age and menopausal state. A highly significant correlation was found between BMC and TBBM in the patients (r = 0.84, SEE = 13.0%) as well as in the controls (r = 0.77, SEE 10.5%). Moreover, the intercepts and the slopes were virtually of the same order. Subdividing the patients according to glucocorticoid treatment the same high correlations were shown in the two subgroups. As a group the patients on glucocorticoids had a highly significant generalized osteopenia (a reduction of TBBM of 26 % compared to normals). The patients on other anti-inflammatory drugs had a significant, but less pronounced generalized osteopenia (a reduction of TBBM by 11 % compared to normals). It is concluded, that BMC of the forearm can be used as a valid estimate of total body calcium in groups of patients with rheumatoid arthritis and in normal subjects.
Similar content being viewed by others
References
Saville, P.D., Kharmosh, O. Osteoporosis of rheumatoid arthritis: Influence of age, sex and corticosteroids. Arthritis Rheum, 1967, 10, 423–430.
Bjelle, A.O., Nilsson, B.E. Osteoporosis in rheumatoid arthritis. Calcif Tissue Int, 1970, 5, 327–332.
Duncan, H. Osteoporosis in rheumatoid arthritis and corticosteroid induced Osteoporosis. Orthop Clin North Am, 1972, 3, 571–583.
Kennedy, A.C., Smith, D.A., Anton, H.C., Buchanan, W.W. Generalised and localised bone loss in patients with rheumatoid arthritis. Scand J Rheumatol, 1975, 4, 209–215.
Virtama, P., Helelä, T., Kalliomäki, J.L. Osteoporosis in rheumatoid arthtitis. Acta Rheum Scand, 1968, 14, 276–284.
Oka, M., Rekonen, A., Kuikka, J., Anttinen, J. Bone mineral density in rheumatoid arthritis measured by the gamma transmission method. Scand J Rheumatol, 1975, 4, 28–32.
Barnett, E., Nordin, B.E.C. The radiological diagnosis of osteoporosis: a new approach. Clin Radiol, 1959, 166–174.
Mueller, M.N., Jurist, J.M. Skeletal status in rheumatoid arthritis. A preliminary report. Arthritis Rheum, 1973, 16, 66–70.
Zanzi, I., Roginsky, M.S., Ellis, K.J., Blau, S., Cohn, S.H. Skeletal mass in rheumatoid arthritis: A comparison with forearm bone mineral content. AJR, 1976, 126, 1305–1306.
Reid, D.M., Kennedy, N.S.J., Smith, M.A., Tothill, P., Nuki, G. Total body calcium in rheumatoid arthritis: effects of disease activity and corticosteroid treatment. Br Med J, 1982, 285, 330–332.
Peppler, W.W., Mazess, R.B. Total body bone mineral and lean body mass by dual-photon absorptiometry. I. Theory and measurement procedure. Calcif Tissue Int, 1981, 33, 353–359.
Mazess, R.B., Peppler, W.W., Chesnut, C.H., Nelp, W.B., Cohn, S.H. Zanzi, I. Total body bone mineral and lean body mass by dual-photon absorptiometry. II. Comparison with total body calcium by neutron activation analysis. Calcif Tissue Int, 1981, 33, 361–363.
Gotfredsen, A., Borg, J., Mazess, R.B., Christiansen, C. In vivo estimation of total body bone mineral by dual photon absorptiometry. Precision and accuracy. Clin Physiol. In press.
Steinbrocker, O., Traeger, C.H., Batterman, R.C. Therapeutic criteria in rheumatoid arthritis. JAMA, 1949, 140, 659–662.
Christiansen, C., Rødbro, P., Jensen, H. Bone mineral content in the forearm measured by photon absorptiometry. Scand. J Clin Lab Invest, 1975, 35, 323–330.
Christiansen, C., Rødbro, P. Estimation of total body calcium from the bone mineral content of the forearm. Scand J Clin Lab Invest, 1975, 35, 425–431.
Rickers, H., Balslev, J., Foltved, H., Rødbro, P. Bone mineral content before and after intestinal bypass operation in obese patients. Acta Med Scand, 1981, 209, 203–207.
Christiansen, C., Rødbro, P. Long-term reproducibility of bone mineral content measurements. Scand J Clin Lab Invest, 1977, 37, 321–323.
Boddy, K., King, P.C., Hume, R., Weyers, E. The relation of total body potassium to height, weight, and age in normal adults. J Clin Pathol, 1972, 25, 512–517.
Christiansen, C., Rødbro, P. Bone mineral content and estimated total body calcium in normal adults. Scand J Clin Lab Invest, 1975, 35, 433–439.
McConkey, B., Fraser, G.M., Bligh A.S. Osteoporosis and purpura in rheumatoid disease: prevalence and relation to treatment with corticosteroids. QJ Med, 1962, 55, 419–427.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Als, O.S., Gotfredsen, A. & Christiansen, C. Relationship between local and total bone mineral in patients with rheumatoid arthritis and normal subjects. Clin Rheumatol 2, 265–271 (1983). https://doi.org/10.1007/BF02041401
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02041401