Prevalence and risk factors associated with vertebral osteoporotic fractures in patients with rheumatoid arthritis

Background:People with rheumatoid arthritis (RA) are at high risk for cardiovascular diseases (CVD) and CVD mortality. Reduced Chronotropic response (CR), which produces exercise intolerance, is known as a contributing factor to CVD and mortality. Studies have shown that people with RA have reduced CR. However, knowledge about the factors associated with CR in people with RA is limited.Objectives:To explore the factors associated with CR including CVD risk factors, inflammatory markers and cardiorespiratory fitness (VO2 peak).Methods:106 people with RA completed a treadmill exercise tolerance test while heart rate (HR) was monitored via 12 leads ECG. CR was defined as the percentage of [(achieved peak HR minus resting HR) divided by (age-predicted maximum HR minus resting HR)]. Serological CVD risk factors and inflammatory markers including lipids profile, markers of insulin resistance and sensitivity (HOMA, QUICKi), high sensitivity C-reactive protein (hsCRP), erythrocyte sedimentation rate (ESR), fibrinogen and white blood cells (WBC) were examined via a fasted blood sample. VO2 peak was assessed via breath-by-breath gas analysis.Results:34% had reduced CR based on the cut-off value (≤ 80%) and the average CR was 86.2 ± 21%. Body mass index (r=-0.33, p=.001), HOMA (r=-0.26, p=.009), hsCRP (r=-0.23, p=.02), ESR (r=-0.21, p=.04), fibrinogen (r=-0.2, p=.05), WBC (r=-0.21, p=.04) were inversely associated with CR, whereas, high density lipoprotein (HDL) (r=0.43, p<.001), QUICKi (r=0.31, p=.002), and VO2 peak (r=0.4, p<.001) were positively associated with CR. When all the variables were entered into a stepwise linear regression, HDL (p<.001) and VO2 peak (p=.009) were independently associated with CR.Conclusion:The current findings suggest that CR in RA was associated with many CVD risk factors, inflammatory markers, and cardiorespiratory fitness. Among all the varibales, HDL and cardiorespiratory fitness were moderately and independently associated with CR. Future studies should investigate the effect of improving these associated variables on CR in people with RA via exercise training programes.Acknowledgements:Thanks to physical activity in Rheumatoid arthritis research team and Research department in Dudley Hospital. Sincere appreciation and gratitude to Dr Jet Veldhuizen van Zanten, Prof. Joan Duda, and Prof. George Kitas from the University of Birmingham and Prof. George Metsios from the University of Wolverhampton.Disclosure of Interests:None declared

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AB0462 Risk Factors Associated with Opioid Treatment of Patients with Rheumatoid Arthritis

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2014-eular.2414 ◽

2014 ◽

Vol 73 (Suppl 2) ◽

pp. 960.3-961

Author(s):

H. Kikuchi ◽

W. Shimada ◽

M. Kamiya ◽

S. Sohen ◽

N. Okada

Keyword(s):

Rheumatoid Arthritis ◽

Risk Factors ◽

Opioid Treatment ◽

Factors Associated

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Risk Factors Associated With the Cumulative Survival of Low-Dose Methotrexate in 273 Japanese Patients With Rheumatoid Arthritis

JCR Journal of Clinical Rheumatology ◽

10.1097/01.rhu.0000260526.29331.a8 ◽

2007 ◽

Vol 13 (2) ◽

pp. 73-78 ◽

Cited By ~ 7

Author(s):

Haruko Ideguchi ◽

Shigeru Ohno ◽

Yoshiaki Ishigatsubo

Keyword(s):

Rheumatoid Arthritis ◽

Risk Factors ◽

Low Dose ◽

Japanese Patients ◽

Cumulative Survival ◽

Factors Associated ◽

Dose Methotrexate

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Risk factors for symptomatic Avascular Necrosis (AVN) in a multi-ethnic Systemic Lupus Erythematosus (SLE) cohort

PLoS ONE ◽

10.1371/journal.pone.0248845 ◽

2021 ◽

Vol 16 (3) ◽

pp. e0248845

Author(s):

Syahrul Sazliyana Shaharir ◽

Siew Huoy Chua ◽

Rozita Mohd ◽

Ruslinda Mustafar ◽

Malehah Mohd Noh ◽

...

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Avascular Necrosis ◽

Lupus Erythematosus ◽

Osteoporotic Fractures ◽

Protective Effects ◽

Regression Analyses ◽

Mobility Limitations ◽

Factors Associated ◽

Multivariable Logistic Regression

Avascular necrosis of bone (AVN) is increasingly being recognized as a complication of SLE and causes significant disability due to pain and mobility limitations. We studied the prevalence and factors associated with avascular necrosis (AVN) in a multiethnic SLE cohort. SLE patients who visited the outpatient clinic from October 2017 to April 2019 were considered eligible. Their medical records were reviewed to identify patients who developed symptomatic AVN, as confirmed by either magnetic resonance imaging or plain radiography. Subsequently, their SLE disease characteristics and treatment were compared with the characteristics of patients who did not have AVN. Multivariable logistic regression analyses were performed to determine the independent factors associated with AVN among the multiethnic SLE cohort. A total of 390 patients were recruited, and the majority of them were females (92.6%); the patients were predominantly of Malay ethnicity (59.5%), followed by Chinese (35.9%) and Indian (4.6%). The prevalence of symptomatic AVN was 14.1%, and the mean age of AVN diagnosis was 37.6 ± 14.4 years. Both univariate and multivariable logistic regression analyses revealed that a longer disease duration, high LDL-C (low density lipoprotein cholesterol), positive anti-cardiolipin (aCL) IgG and anti-dsDNA results, a history of an oral prednisolone dose of more than 30 mg daily for at least 4 weeks and osteoporotic fractures were significantly associated with AVN. On the other hand, hydroxychloroquin (HCQ), mycophenolate mofetil (MMF) and bisphosphonate use were associated with a lower risk of AVN. No associations with ethnicity were found. In conclusion, several modifiable risk factors were found to be associated with AVN, and these factors may be used to identify patients who are at high risk of developing such complications. The potential protective effects of HCQ, MMF and bisphosphonates warrant additional studies.

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Risk factors for osteoporotic fractures and low bone density in pre and postmenopausal women

Revista de Saúde Pública ◽

10.1590/s0034-89102010000300011 ◽

2010 ◽

Vol 44 (3) ◽

pp. 479-485 ◽

Cited By ~ 43

Author(s):

Marcelo M Pinheiro ◽

Edgard T dos Reis Neto ◽

Flávia S Machado ◽

Felipe Omura ◽

Jeane H K Yang ◽

...

Keyword(s):

Physical Activity ◽

Risk Factors ◽

Bone Mass ◽

Osteoporotic Fracture ◽

Osteoporotic Fractures ◽

Southeastern Brazil ◽

Current Smoking ◽

Factors Associated ◽

Previous Fracture ◽

Low Trauma Fracture

OBJECTIVE: To estimate the prevalence and analyze risk factors associated to osteoporosis and low-trauma fracture in women. METHODS: Cross-sectional study including a total of 4,332 women older than 40 attending primary care services in the Greater São Paulo, Southeastern Brazil, between 2004 and 2007. Anthropometrical and gynecological data and information about lifestyle habits, previous fracture, medical history, food intake and physical activity were obtained through individual quantitative interviews. Low-trauma fracture was defined as that resulting from a fall from standing height or less in individuals 50 years or older. Multiple logistic regression models were designed having osteoporotic fracture and bone mineral density (BMD) as the dependent variables and all other parameters as the independent ones. The significance level was set at p<0.05. RESULTS: The prevalence of osteoporosis and osteoporotic fractures was 33% and 11.5%, respectively. The main risk factors associated with low bone mass were age (OR=1.07; 95% CI: 1.06;1.08), time since menopause (OR=2.16; 95% CI: 1.49;3.14), previous fracture (OR=2.62; 95% CI: 2.08;3.29) and current smoking (OR=1.45; 95% CI: 1.13;1.85). BMI (OR=0.88; 95% CI: 0.86;0.89), regular physical activity (OR=0.78; 95% CI: 0.65;0.94) and hormone replacement therapy (OR=0.43; 95% CI: 0.33;0.56) had a protective effect on bone mass. Risk factors significantly associated with osteoporotic fractures were age (OR=1.05; 95% CI: 1.04;1.06), time since menopause (OR=4.12; 95% CI: 1.79;9.48), familial history of hip fracture (OR=3.59; 95% CI: 2.88;4.47) and low BMD (OR=2.28; 95% CI: 1.85;2.82). CONCLUSIONS: Advanced age, menopause, low-trauma fracture and current smoking are major risk factors associated with low BMD and osteoporotic fracture. The clinical use of these parameters to identify women at higher risk for fractures might be a reasonable strategy to improve the management of osteoporosis.

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