Advertisement

Journal of Bone and Mineral Metabolism

, Volume 15, Issue 1, pp 30–33 | Cite as

Reduction of bone mineral density in rheumatoid arthritis: A longitudinal study

  • Shigehito Miyamoto
  • Yasunori Kageyama
  • Takao Ozeki
  • Motohiro Suzuki
  • Tetsuo Inoue
Original Articles

Abstract

In the last decade, more accurate quantitative methods to assess bone mass in vivo have become available. We have applied these techniques to assess periodic changes of bone loss in rheumatoid arthritis (RA) patients. In this longitudinal study, 132 female RA patients were divided into two groups. The first group of 90 patients were postmenopausal, with a mean age of 60.2 years (PM group), whereas the second group of 42 patients were premenopausal, with a mean age of 42.7 years (M group). The clinical courses of these patients were followed for an average of 3 years. Bone mineral density (BMD) in the lumbar spine (L2–L4), and the femoral neck were measured by dual-energy X-ray absorptiometry (DXA), and second metacarpal bone mineral density was measured by using densitometric techniques periodically. Reduction of BMD in the lumbar spine was significant in both groups (P<0.01–0.05), but there was no statistical difference between the two groups. The BMD of the femoral neck had a tendency to decrease but this was not significant. The predictors for periodic bone loss in the PM group were aging and nutritional factors, whereas for the M group they were indices of rheumatoid arthritis disease activity.

Key words

rheumatoid arthritis (RA) dual-energy X-ray absorptiometry (DXA) osteoporosis bone mineral density (BMD) 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Ropes MW, Bernett GA, Cobb S, Jacox R, Jessar RA (1958) 1958 revision of diagnostic criteria for rheumatoid arthritis. Bull Rheum Dis 9:175–176PubMedGoogle Scholar
  2. 2.
    Saville PD, Kharmosh O (1967) Osteoporosis of rheumatoid arthritis: influence of age, sex and corticosteroids. Arthritis Rheum 10:423–430PubMedGoogle Scholar
  3. 3.
    Kennedy AC, Smith DA, Anton HC, Buchann WW (1975) Generalized and localized bone loss in patients with rheumatoid arthritis. Scand J Rheumatol 4:209–215PubMedGoogle Scholar
  4. 4.
    Mueller MN, Jurist JM (1973) Skeletal status in rheumatoid arthritis. Arthritis Rheum 16:66–70PubMedGoogle Scholar
  5. 5.
    Christian C, Rodprop P (1975) Skeletal status in patients with rheumatoid arthritis. Acta Med Scand 198:453–454CrossRefGoogle Scholar
  6. 6.
    Hancock DA, Aseidu-Offei S, Atkinson PJ, Read JW, Wright V (1978) Femoral bone loss in patients with rheumatoid arthritis and osteoarthrosis. Rheumatol Rehabil 17:65–71PubMedCrossRefGoogle Scholar
  7. 7.
    Als OS, Christiansen C, Hellesen C (1984) Prevalence of decreased bone mass in rheumatoid arthritis: relation to anti-inflammatory treatment. Clin Rheumatol 3:201–208PubMedCrossRefGoogle Scholar
  8. 8.
    Inoue T, Kushida K, Miyamoto S, Sumi Y, Orimo H, Yamashita G (1983) Quantitative asessment of bone density on X-ray picture. J Jpn Orthop Ass 57:1923–1936Google Scholar
  9. 9.
    Steinbrocker O, Traeger CH, Batterman RC (1949) Therapeutic criteria in rheumatoid arthritis. JAMA 140:659–662Google Scholar
  10. 10.
    Sambrook PN, Ansell BM, Foster S, Grumpel GM, Hesp R, Reeve J, Zanelli JM (1985) Bone turnover in early rheumatoid arthritis. 2. Longitudinal bone density studies. Ann Rheum Dis 44:580–584PubMedGoogle Scholar
  11. 11.
    Sambrook PN, Eisman JA, Champion GD, Yeates MG (1987) Determinants of axial bone loss in rheumatoid arthritis. Arthritis Rheum 30:721–728PubMedGoogle Scholar
  12. 12.
    Cohn SH (1982) Techniques for determining the efficacy of treatment of osteoporosis. Calcif Tissue Int 34:433–438PubMedCrossRefGoogle Scholar
  13. 13.
    Miyamoto S, Inoue T (1991) Osteoporosis and rheumatoid arthritis. J Chuubu Rheum Assoc 22:4–10Google Scholar
  14. 14.
    Teshima R, Yamamoto K, Kishimoto H, Morio Y, Hagino H, Maeyama I (1987) Osteoporotic change in rhehumatoid arthritis. J Jpn Orthop Ass 61:289–297Google Scholar
  15. 15.
    Als OS, Gotferdsen A, Riis BJ, Christiansen C (1985) Are disease duration and degree of functional impairment determinants of bone loss in rheumatoid arthritis? Ann Rheum Dis 44:406–411PubMedGoogle Scholar
  16. 16.
    Virtama P, Helella T, Kalliomaka JL (1968) Osteoporosis in rheumatoid arthritis: a follow up study. Acta Rheumatol Scand 14:276–284PubMedGoogle Scholar
  17. 17.
    Oka M, Reckonen A, Kuikka J, Anttinen J (1975) Bone mineral density in rheumatoid arthritis measured by the gamma transmission method. Scand J Rheumatol 4:28–32PubMedGoogle Scholar
  18. 18.
    Krolner B, Pors Nielsen S (1980) Measurement of bone mineral content (BMC) of the lumbar spine. 1. Theory and application of a new two dimensional dual photon attenuation method. Scand J Clin Lab Invest 40:653–663PubMedGoogle Scholar
  19. 19.
    Riggs BL, Wahner HW, Dunn WL, Mazess RB, Offord KP, Melton LJ III (1985) Differential changes in bone mineral density of the appendicular and axial skeleton with aging. J Clin Invest 67:328–335CrossRefGoogle Scholar

Copyright information

© Springer-Verlag 1997

Authors and Affiliations

  • Shigehito Miyamoto
    • 1
  • Yasunori Kageyama
    • 1
  • Takao Ozeki
    • 1
  • Motohiro Suzuki
    • 1
  • Tetsuo Inoue
    • 1
  1. 1.Department of Orthopedic SurgeryHamamatsu University School of MedicineHamamatsuJapan

Personalised recommendations