scholarly journals Changes in bone mineral density over 10 years in patients with early rheumatoid arthritis

RMD Open ◽  
2020 ◽  
Vol 6 (1) ◽  
pp. e001142
Author(s):  
Lisa Theander ◽  
Minna Willim ◽  
Jan Åke Nilsson ◽  
Magnus Karlsson ◽  
Kristina E Åkesson ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Femoral Neck ◽  
Z Score ◽  
Mineral Density ◽  
Early Ra ◽  
Z Scores ◽  
The Mean

ObjectivesTo investigate changes in bone mineral density (BMD) in patients with early rheumatoid arthritis (RA) over a 10-year period.MethodsConsecutive patients with early RA (symptom duration <12 months) were followed according to a structured programme and examined with dual-energy X-ray absorptiometry (DXA) at inclusion and after 2, 5 and 10 years. Mean Z-scores over the study period were estimated using mixed linear effect models. Changes in Z-scores between follow-up visits were analysed using paired T-tests.ResultsAt inclusion, 220 patients were examined with DXA. At the femoral neck, the mean Z-score over 10 years was −0.33 (95 % CI −0.57 to −0.08) in men and −0.07 (−0.22 to 0.08) in women. Men had significantly lower BMD at the femoral neck than expected by age at inclusion (intercept Z-score value −0.35; 95 % CI −0.61 to −0.09), whereas there was no such difference in women. At the lumbar spine, the mean Z-score over the study period for men was −0.05 (−0.29 to 0.19) and for women 0.06 (−0.10 to 0.21). In paired comparisons of BMD at different follow-up visits, femoral neck Z-scores for men decreased significantly from inclusion to the 5-year follow-up. After 5 years, no further reduction was seen.ConclusionsIn this observational study of a limited sample, men with early RA had reduced femoral neck BMD at diagnosis, with a further significant but marginal decline during the first 5 years. Lumbar spine BMD Z-scores were not reduced in men or women with early RA. Data on 10-year follow-up were limited.

FRI0068 LIPID PROFILE AND BONE MINERAL DENSITY IN PATIENTS WITH RHEUMATOID ARTHRITIS: IS THERE AN ADDED RISK OF OSTEOPOROSIS?

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 610.1-611
Author(s):  
B. Touil ◽  
H. Azzouzi ◽  
O. Lamkhanat ◽  
F. Chennouf ◽  
I. Linda
Keyword(s):  
Rheumatoid Arthritis ◽  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Linear Regression ◽  
Femoral Neck ◽  
Lipid Profile ◽  
Density Lipoprotein ◽  
Mineral Density ◽  
High Tc ◽  
High Concentrations

Background:Bone is a target in many inflammatory rheumatic diseases such as rheumatoid arthritis (RA). It has been supposed that an atherogenic lipid profile could be associated with lower bone mineral density (BMD) and vertebral fractures (VF).Objectives:We aimed to evaluate the relationship between the lipid profile, BMD and the presence of VF in RA patients.Methods:A cross sectional study was conducted in a population of 169 established RA. In each subject we evaluated the body mass index (BMI), tobacco use, alcohol consumption, presence of diabetes and high blood pression, lipid profile (total cholesterol (TC), High density lipoprotein cholesterol (HDLc), low density lipoprotein cholesterol (LDLc), triglycerides (TG), and VF. RA characteristics were also assessed (disease duration, disease activity score (DAS), auto antibodies, corticosteroid intake, and secondary sjogren’s syndrome). BMD was measured by dual energy X-ray absorptiometry (DXA) in lumbar spine and femoral neck. Logistic and linear regression were performed with SPSS 20, both BMD and VF were assessed as dependent variables.Results:The mean age was 55.5±11.9 years, with a female predominance (152 women). The average BMI was 26.79 ± 5.36. We had 24.3 % of hypertensive patients and 16.6 % of diabetics. The average lipid concentrations were 4.39±1 mmol/L for TC, 1.293±0.36 mmol/L for HDLc, 2.74±0.80 mmol/L for LDLc and 1.25±0.62 mmol/L for TG. At the linear regression there was no correlation between plasma lipid concentrations and BMD, whether at the lumbar spine or the femoral neck. However we found a significant correlation between VF and high TC concentrations (p=0.043, OR: 2.864, 95% IC [1.036-7.922]). At the multivariate regression, high TC levels were still associated with VF, adjusted in BMI, age and the duration of corticosteroid use (p=0.006, OR: 6.07, 95% CI[1.69- 21.77]). The same finding was observed between high concentrations of HDLc and the prevalence of VF adjusted in the same variables (p=0.006, OR: 197.01, 95% CI [4.64-8363.51]).Conclusion:Although there was no relation between lipid plasma levels and BMD in our population. There was a significant association between high concentrations of TC, HDLc and the prevalence of VF.Disclosure of Interests:None declared

Estimation of Central Osteopenia in Children With Chronic Polyarthritis Treated With Glucocorticoids

PEDIATRICS ◽  
1993 ◽  
Vol 91 (6) ◽  
pp. 1127-1130
Author(s):  
Antero Kotaniemi ◽  
Anneli Savolainen ◽  
Hannu Kautiainen ◽  
Heikki Kröger
Keyword(s):  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Femoral Neck ◽  
Bone Mineral ◽  
Bone Size ◽  
Mineral Density ◽  
Volumetric Density ◽  
Chronic Polyarthritis ◽  
The Mean ◽  
Bone Volumetric Density

Study objective. To investigate the degree and determinants of osteopenia in juvenile chronic polyarthritis. Design. Retrospective case-control study of central bone mineral density. Setting. Rheumatism Foundation Hospital and Kuopio University Hospital, Finland. Subjects. A sample of 43 girls aged 7 to 19 with juvenile chronic polyarthritis treated with systemic glucocorticoids and a control sample of 44 healthy girls matched for age. Main outcome measures. Bone mineral density and bone size (width) measured by dual-energy x-ray absorptiometry and bone volumetric density calculated as an approximation of true bone density at both the lumbar spine and femoral neck. Results. The girls with juvenile chronic arthritis had reduced bone mineral density, bone size, and bone volumetric density at both the lumbar spine and femoral neck (statistically significant findings, P = .022 for the bone size of the femoral neck and P &lt; .001 for the other parameters). At the spine, the mean bone mineral density was 80%, the mean bone size 89%, and the mean bone volumetric density 89% of the values in the control group. At the femoral neck, the values were 78%, 93%, and 83%, respectively. The groups were matched for age, but the girls with arthritis were smaller and lighter. In the juvenile arthritis group, the femoral bone mineral density and bone volumetric density and the spinal bone width correlated negatively with the mean glucocorticoid dose. Conclusion. Axial bone mineral density is clearly reduced in severe juvenile polyarthritis and is mediated by both decreased bone volumetric density and diminished growth.

Evaluation of Bone Mineral Density in Children with Sickle Cell Anemia.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 106-106
Author(s):  
Ashutosh Lal ◽  
Ellen Fung ◽  
Bamidele Kammen ◽  
Zahra Pakbaz ◽  
Nancy Sweeters ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Sickle Cell ◽  
Bone Mineral ◽  
Reference Data ◽  
Growth Failure ◽  
Red Cell ◽  
Z Score ◽  
Mineral Density ◽  
Z Scores

Abstract Background : Reduced bone mineral density (BMD) has been reported in adults and children with sickle cell anemia (SCA). Dual energy x-ray absorptiometry (DXA) is routinely used for measuring BMD because of less radiation exposure and lower cost. However, changes in vertebral body shape, marrow hyperplasia and bone infarction due to SCA may affect the evaluation of BMD with DXA. Hence, we compared DXA with quantitative computerized tomography (QCT), which measures true volumetric density, and may be less influenced by bone changes. Methods : The study enrolled children between 9–19 years of age with SCA, and one or more severe manifestations: &gt;2 hospital admissions/year, growth failure, avascular necrosis, or regular red cell transfusions for sickle cell-related complications. BMD of lumbar spine was determined by performing DXA of lumbar spine (Hologic Delphi-A, Bedford, MA). The apparent volumetric bone mineral density (BMAD) was calculated from bone mineral content, and compared to age, sex and ethnicity-matched reference data. BMD of the lumbar spine was also measured by QCT (Mindways Software, San Francisco, CA), and compared to age and sex-appropriate reference data. Results : The study has enrolled 25 patients (13 females and 12 males), of which 16 were younger than 14 years. In 6 children the height was &lt;10th centile for age. Thirteen patients were on regular transfusions for &gt;6 months, including 10 who had been transfused for &gt;2 years. Calcium intake, assessed by a standardized questionnaire, was less than recommended dietary allowance in 13 patients. The z-score for BMAD determined by DXA was &gt; −1.0 in 8, between −1.0 and −2.0 in 5, and &lt; −2.0 in 12 patients. The z-score for lumbar spine by QCT was &gt; −1.0 in 20, between −1.0 and −2.0 in 1 and &lt; −2.0 in 4 patients. DXA-derived BMD (areal density) and BMAD (apparent volumetric density) z-scores did not differ significantly (p=0.16). On the other hand, the paired values of z-scores by DXA (BMAD) and QCT were significantly different (p=.002). When z-scores were categorized as greater or less than −1.0, the results were concordant in 13 (both DXA and QCT normal in 8, and both DXA and QCT abnormal in 5), and discordant in 12 cases (abnormal DXA with normal QCT in every case). Among patients in discordant group, 9/12 had been on regular red cell transfusions for &gt;6 months, compared to 4/13 with concordant results (p=.047). There was no difference in the serum ferritin values between the two groups (p=.685). No significant difference in the prevalence of low BMAD z-scores was detected between groups based upon age, calcium intake, or growth failure. Five out of the 12 patients with BMAD z-score &lt; −2.0 were not on regular transfusion program. Conclusions : Almost half of the children with SCA had BMD below −2 standard deviations compared to age-matched controls. Low BMD was observed in chronically transfused as well as non-transfused children. In comparison, 16% of the patients were classified as low BMD (z &lt; −2.0) by QCT. The paired DXA/QCT results were discordant in half of the sample, with patients on regular transfusions for &gt;6 months more likely to have normal QCT results. It is likely that the reduction in marrow hyperplasia following initiation of regular transfusions may disproportionately affect the trabecular BMD measured by QCT. Longitudinal evaluation of BMD in patients starting on transfusion program could help to define the effect of transfusions on measures of BMD in SCA.

scholarly journals Alcohol consumption and bone mineral density in elderly women

2012 ◽  
Vol 16 (4) ◽  
pp. 704-712 ◽  
Author(s):  
Isolde Sommer ◽  
Arja T Erkkilä ◽  
Ritva Järvinen ◽  
Jaakko Mursu ◽  
Joonas Sirola ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Alcohol Consumption ◽  
Femoral Neck ◽  
Bone Mineral ◽  
Alcohol Intake ◽  
Elderly Women ◽  
Mineral Density ◽  
Lifestyle Questionnaire

AbstractObjectiveFindings regarding alcohol consumption and bone mineral density (BMD) in elderly women have been inconsistent. The objective of the present study was to explore the association of alcohol intake with BMD in elderly women.DesignThis cohort study included women from the population-based Kuopio Osteoporosis Risk Factor and Prevention – Fracture Prevention Study (OSTPRE-FPS). Alcohol intake and potential confounders were assessed at baseline and after 3 years of follow-up using a lifestyle questionnaire. In addition, an FFQ was distributed in the third year to measure dietary intake, including alcohol. Women underwent BMD measurements at the femoral neck and lumbar spine at baseline and after 3 years of follow-up.SettingKuopio Province, Finland.SubjectsThree hundred elderly women (mean age 67·8 years) who provided both BMD measurements and FFQ data.ResultsAlcohol consumption estimated from the FFQ and lifestyle questionnaire was significantly associated with BMD at both measurement sites after adjustment for potential confounders, including lifestyle and dietary factors (P < 0·05). Using the FFQ, women drinking >3 alcoholic drinks/week had significantly higher BMD than abstainers, 12·0 % at the femoral neck and 9·2 % at the lumbar spine. Results based on the lifestyle questionnaire showed higher BMD values for all alcohol-consuming women at the femoral neck and for women drinking 1–3 alcoholic beverages/week at the lumbar spine, compared with non-users.ConclusionsThe results from OSTPRE-FPS suggest that low to moderate alcohol intake may exert protective effects on bone health in elderly women.

Relation of the Serum Levels of DKK-1 and Osteoprotegerin with Bone Mass in Tightly Controlled Rheumatoid Arthritis.

2020 ◽  
Vol 16 ◽  
Author(s):  
Carmen Gómez-Vaquero ◽  
Irene Martín ◽  
Andrea Zacarías ◽  
Pedro Alía ◽  
Estíbaliz Loza ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Lumbar Spine ◽  
Femoral Neck ◽  
Serum Levels ◽  
Mineral Density ◽  
Annual Percent Change ◽  
Activity Measures ◽  
Mean Time

Objective: To analyze the association between serum levels of osteoprotegerin (OPG) and Dickkopf-related protein 1 (DKK-1) and the annual percent change (%) in bone mineral density (BMD) in patients with tightly controlled rheumatoid arthritis (RA). Methods: Observational mixed-study. RA patients followed-up with a tight-control strategy were included. Bone densitometries were performed at baseline (T0) and follow-up (T1) and serum levels of OPG and DKK-1 were measured by ELISA also in T0 and T1; additional clinical variables included disease activity measures, and treatment for RA and osteoporosis. Descriptive bivariate and multivariate analyses, stratified by gender, were performed. Results: We included 97 RA patients (70% female, with a mean age of 53 years, and 76% with low activity by DAS28); 95% were treated with DMARDs and 37% with anti-osteoporotic drugs. Mean time between T0 and T1 was 2.7 years. Most patients had their BMD improved. The mean %BMD was +0.42% for lumbar spine, +0.15% for femoral neck and +0.91% for total femur. In men, baseline OPG was significantly associated with higher BMD loss (β coefficient -0.64) at femoral neck. In women, DKK-1 was associated with higher BMD loss at femoral neck (β coefficient -0.09), and total femur (β coefficient -0.11); however, DKK-1 was associated with lower BMD loss at lumbar spine (β coefficient 0.06). Conclusion: In tightly controlled RA patients, we have found no evidence of bone loss. The role of DKK1 and OPG seems small and might be related to sex and to location.

Effect of Zoledronic Acid on Bone Mineral Density in Thalassemia-Induced Osteoporosis: Results of a Phase II Clinical Trial.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 3826-3826
Author(s):  
Ali Taher ◽  
Sami Azar ◽  
Wael Shamseddeen ◽  
Dany Habr ◽  
Adlette Inati ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Zoledronic Acid ◽  
Femoral Neck ◽  
Adverse Events ◽  
Bone Mineral ◽  
Beta Thalassemia ◽  
Mineral Density ◽  
Significant Change

Abstract Background: Osteoporosis is an important cause of morbidity in beta-thalassemia patients. Bisphosphonates are potent inhibitors of osteoclast activity and have been recently used for the treatment of osteoporosis in beta-thalassemia. The aim of this study is to assess the efficacy and safety of zoledronic acid in Lebanese thalassemics with osteoporosis. Methods: Eighteen thalassemic patients (13 thalassemia major and 5 intermedia) with osteoporosis defined as Z-score &lt;−2.5 were given zoledronic acid 4 mg i.v. every 3 months over a period of 12 months (Total of 4 doses administered). The efficacy of treatment was assessed by measuring Bone Mineral Density (BMD) at the lumbar spine, femoral neck and hip at baseline, 6 and 12 months. Other efficacy measurements included markers of bone formation and resorption (bone alkaline phosphatase (BAP), osteocalcin (OC), and urinary deoxypyridinoline (Dpd)), assessment of pain score, analgesic score, and performance score measured at baseline and at 3-month intervals. Safety assessment included regular physical exams, standard hematology and clinical chemistry tests, and adverse events recording. All patients were on Ca/Vitamin D supplementation prior to and during the study. Ten thalassemic osteoporotic patients were followed up only with serial BMDs as controls. Results: The characteristics of all patients are shown in Table 1. Both groups had no significant difference with respect to age, gender and baseline BMD. Patients taking zoledronic acid had a significant increase in their spine, femoral neck, trochanter and total hip BMD measurements over the 12-month period (all p-values&lt;0.05). Patients in the control group, on the other hand, did not have any significant change except in the spine BMD. The BMD values are presented in Table 2. There was a significant change in the levels of the OC and BAP over the 12-month follow-up in the treatment group (p=0.00 for both). Dpd levels did not significantly change overall (p=0.06) although they decreased throughout the study. Reported adverse events included joint pain in 9 patients (50%) after the 1st dose and in 2 (11.1%) after the 2nd dose and responding very well to oral analgesics. Two patients (11.1%) had perioral numbness and 3 (16.7%) had low grade fever after the 1st dose. No treatment-related adverse events were reported after the 3rd and 4th doses. No patients withdrew from the study. Conclusions: Treatment of Lebanese thalassemic osteoporotic patients with zoledronic acid 4 mg every 3 months is effective in increasing BMD at the lumbar spine and hip and is well-tolerated. Well-controlled studies with longer follow-up are needed to determine the fracture-reduction benefits and the most optimal zoledronic acid treatment dose and frequency in this patient population. Table 1: Main characteristics of the studied groups Table 2: BMD values of the treatment and control groups

Bone Mineral Density in Transfusion Independent Thalassemia Patients.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 3353-3353
Author(s):  
Zahra Pakbaz ◽  
Zhe Zhang ◽  
Ellen Fung ◽  
Nancy Sweeters ◽  
Sylvia Singer ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Family History ◽  
Bone Mineral ◽  
Z Score ◽  
Low Bone Mass ◽  
Mineral Density ◽  
Patients Âgés ◽  
Z Scores ◽  
History Of ◽  
The Mean

Abstract Low bone mineral density (BMD) is commonly seen in regularly transfused thalassemia patients; however, there have been few reports for bone mineral density assessment in transfusion independent thalassemia patients. The present report includes the results of BMD assessments in patients with transfusion independent thalassemia who were referred to the bone density clinic through 2002–2006. BMD was evaluated by dual energy x-ray absorptiometry (DXA, Hologic Delphi A). A convenience sample of 24 patients (Females=15) with transfusion independent thalassemia were measured with a mean age of 22.1 ± 13.8 years. Subjects younger than 10 yrs old (n = 7) underwent scans for Lumbar spine (LS; L1-L4) and whole body (WB), patients ages 10–20 (n = 5) were assessed for LS, WB, and non-dominant hip, and for patients older than 20 (n = 12), LS and hip scans were completed. Z-scores specific for age and gender were generated using Zemel BS et al.(J. Bone Min Res 2004) database. Z-scores less than −2.0 were considered as low bone density. Calcium intake was assessed by a brief food frequency questionnaire. Past medical history, medications, history of fractures, and family history of osteoporosis were obtained by chart review and patient interview. Data is presented as Mean ± SD. T-test was used to assess differences in continuous variables. The mean LS Z-score (n = 24) was −1.5 ± 1.0 and the mean hip Z-score (n = 17) was −0.5 ± 1.1. Mean WB Z-score (n = 10) was −2.0 ± 1.2. There was a significant (p<0.001) difference between spine and hip Z-scores. Overall 46% had a Z-score less than −2.0. Thirty-three percent of patients have spine Z-scores of less than −2.0 and 25% spine Z-scores between −2.0 and −1.0. Average spine Z-score in patients younger than 10 years old (n=7) was −1.6 ± 0.5. In WB scans, 50% of the patients had WB Z-scores worse than −2.0. None of the young patients (5–9 yrs; n = 7) consumed inadequate intake of calcium (< 2/3 of RDA age specific) while 75% of patients ages 10–20 (n = 4) years old consumed inadequate intake of calcium (dietary + supplement). Neither spine nor hip Z-score was related to patients’ gender, age, and calcium intake. Two patients reported fractures in the past and two reported family history of osteoporosis. Six patients had delayed puberty and one has hypogonadism. Seven patients have short stature. This data suggests that low bone mass is not only a problem in transfused thalassemia patients, but is also observed in non-transfused patients. The significance and pathophysiology of low bone mass should be studied further in non-transfused patient population, especially in younger children.

scholarly journals POS1106 FRAX AND THE EFFECT OF TERIPARATIDE ON BONE MINERAL DENSITY IN SECONDARY OSTEOPOROSIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 833.2-834
Author(s):  
S. Garcia ◽  
B. M. Fernandes ◽  
M. Rato ◽  
F. Oliveira Pinheiro ◽  
D. Fonseca ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Hip Fracture ◽  
Lumbar Spine ◽  
Femoral Neck ◽  
Fracture Risk ◽  
Bone Mineral ◽  
Fracture Probability ◽  
Mineral Density ◽  
T Score

Background:Teriparatide has been shown to increase spine and hip bone mineral density (BMD) and to reduce vertebral and non-vertebral fractures. (1) It is currently not clear whether the effect of teriparatide is dependent on the baseline risk of fracture or osteoporosis (OP) type, a finding that could have an impact on our therapeutic decision.Objectives:Investigate if there is a relationship between teriparatide effect in BMD and baseline 10-year fracture probability, assessed using FRAX®, in primary and secondary OP patients.Methods:This is a longitudinal, retrospective study including consecutive patients with the diagnosis of OP treated with teriparatide for 24 months, with a ten-year follow-up period, at our rheumatology department. Demographic, clinical, laboratorial, BMD and occurrence of fracture data were collected. The 10-year risk of osteoporotic fracture was estimated using the fracture risk assessment tool (FRAX) v 4.1 with the Portuguese population reference. Statistical analysis was performed using the software SPSS 23.0. Correlations between continuous variables were evaluated with spearman coefficient. p<0.05 was considered statistically significant.Results:Eighty patients (88.8% female, median age 65.00 (59; 75)) were included. Forty-nine patients (61.3%) has secondary OP, mainly of cortisonic etiology (61.2%, n=30). Before treatment, median lumbar spine BMD was 0.870 [0.767, 0.964] g/cm2, median T-score of -2.60 (-3.30, -1.90); median total femur BMD was 0.742 [0.667, 0.863] g/cm2, median T-score of -2.10 (-2.80, -1.30); median femoral neck BMD was 0.671 [0.611, 0.787] g/cm2, median T-score of -2.50 [-3.20, -1.85]. Regarding fracture risk, median FRAX-based 10-year major fracture risk (with BMD) at baseline was 16% [10.0; 23], and median hip fracture risk was 7.2% [3.4; 13.8].The median variation of BMD, after finishing teriparatide treatment, in the spine was 0.107 [0.029; 0.228]; median BMD variation in total femur was 0.013 [-0.013; 0.068] and median BMD femoral neck was 0.046 [-0.002; 0.109]. We observed a numerically superior effect, albeit without any statistical significance, of teriparatide on bone mineral density gain in secondary OP (versus primary OP) at lumbar spine, total femur and femoral neck.Most patients continued anti-osteoporotic treatment with a bisphosphonate (81.2%, n=65) and, during follow-up, 17 patients had an incident fracture (8 hip fractures and 6 vertebral fractures), median of 5 [1.75, 8.25] years after ending teriparatide.We found a discrete correlation between FRAX-based hip fracture probability and the variation of bone mineral density in total femur (Spearman’s coefficient 0.248, p = 0.04). There was no correlation between FRAX-based major fracture probability and and the variation of bone mineral density in the spine or femur. When we separately analyze the relationship between the variation in total hip BMD and the FRAX-based fracture risk, depending on whether it is a secondary or primary OP, we find that the correlation is stronger and only remains in secondary OP (Spearman’s coefficient 0.348, p = 0.03).Conclusion:Our data suggest that teriparatide could be an important weapon in the treatment of secondary cause OP, particularly cortisonic, and in patients at high fracture risk, although further larger studies are needed to confirm these findings.References:[1]Kendler DL, Marin F, Zerbini CAF, Russo LA, Greenspan SL, Zikan V, Bagur A, Malouf-Sierra J, Lakatos P, Fahrleitner-Pammer A, Lespessailles E, Minisola S, Body JJ, Geusens P, Möricke R, López-Romero P. Effects of teriparatide and risedronate on new fractures in post-menopausal women with severe osteoporosis (VERO): a multicentre, double-blind, double-dummy, randomised controlled trial. Lancet. 2018 Jan 20;391(10117):230-240. doi: 10.1016/S0140-6736(17)32137-2.Disclosure of Interests:None declared.

scholarly journals AB0895 RELATIONSHIP BETWEEN BONE MINERAL DENSITY, INFLAMMATORY ACTIVITY AND AUTOIMMUNITY IN A COHORT OF EARLY RHEUMATOID ARTHRITIS PATIENTS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1751.3-1751
Author(s):  
S. Garcia Carazo ◽  
D. Peiteado ◽  
A. Villalva ◽  
L. Nuño ◽  
M. Diaz ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Bone Mineral Density ◽  
Femoral Neck ◽  
Bone Mineral ◽  
Early Rheumatoid Arthritis ◽  
Inflammatory Activity ◽  
Inflammation Marker ◽  
Mineral Density ◽  
Das 28 ◽  
The Mean

Background:The etiology of bone loss in Rheumatoid Arthritis (RA) is multifactorial and systemic inflammation plays a relevant role. Recently, a relationship between autoimmunity and bone mineral density (BMD) has been described in patients with RA.Objectives:To study BMD and biochemical parameters of bone metabolism in a cohort of patients with early rheumatoid arthritis, and assess the relationship between them and autoimmunity and other markers of inflammation.Methods:A prospective longitudinal study was performed. 128 patients from an early Rheumatoid Arthritis Unit (ERAU) were included. All of them fullfilled ACR 2010 classification criteria for RA. Demographic, clinical, biochemical, immunological, radiological and densitometric data, and also inflammatory activity index DAS 28, HAQ functional index, were collected. Any value >20 IU/mL for RF and >30 IU/mL for ACPA was defined as positive.Results:Between January 2009 and June 2017, 801 patients were evaluated in our ERAU. After two years of follow-up, the most frequent definitive diagnoses were: Early RA 221 (27.6%), Undifferentiated Arthritis 97 (12.1%), Psoriatic Arthritis 62 (7.7%), Spondyloarthritis 54 (6.7%) and autoimmune Diseases 28 (3.4%).From the 128 patients with early rheumatoid arthritis evaluated, 104 (81.9%) were ACPA positive and 98 (77.2%) FR positive. The mean BMD in the total column was 0.96 ±0.14 g/cm2 and in the femoral neck was 0.76 ±0.12 g/cm2. No correlation of BMD with autoimmunity markers was found in either of the two locations studied, while a negative relationship between BMD and the PCR inflammation marker (BMD femoral neck: rho-0.203, p = 0.027 and BMD lumbar spine rho =-0.27, p 0.003) was found. The BMD did not correlate with DAS28 nor the HAQ index.The mean baseline serum calcidiol value was 20.7±8 ng/ml, and a negative correlation of basal serum calcidiol with the functional HAQ index was observed (rho=-0.23, p= 0.008). No correlation between other autoimmunity (FR and ACPA) and inflammation (VSG, PCR and DAS 28) markers and vitamin D was found.Conclusion:The BMD in patients with early rheumatoid arthritis of our cohort correlates with the PCR inflammation marker. Unlike other studies shows, in our cohort, serological autoimmunity factors do not have shown to have an independent effect on BMD.References:[1]Llorente I, Merino M, Ortiz AM, et al. Anti-citrullinated protein antibodies are associated with decreased bone mineral density: baseline data from a register of early arthritis patients. Rheumatol Int (2017) 37:799–806Disclosure of Interests:Sara Garcia Carazo: None declared, Diana Peiteado: None declared, Alejandro Villalva: None declared, Laura Nuño: None declared, Mariana Diaz: None declared, Alejandro Balsa Grant/research support from: BMS, Roche, Consultant of: AbbVie, Gilead, Lilly, Pfizer, UCB, Sanofi, Sandoz, Speakers bureau: AbbVie, Lilly, Sanofi, Novartis, Pfizer, UCB, Roche, Nordic, Sandoz, Pilar Aguado: None declared

scholarly journals AB0609 RADIOFREQUENCY ECHOGRAPHIC MULTI-SPECTROMETRY FOR THE ASSESSMENT OF BOTH FEMORA IN PREGNANT WOMEN

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1340.1-1340
Author(s):  
E. Kirilova ◽  
N. Kirilov ◽  
S. Vladeva
Keyword(s):  
Bone Mineral Density ◽  
Femoral Neck ◽  
Pregnant Women ◽  
Bone Mineral ◽  
Dual Energy ◽  
Z Score ◽  
Mineral Density ◽  
X Ray ◽  
The Mean ◽  
The Right

Background:Radiofrequency Echographic Multi-Spectrometry (REMS) is a non-ionizing innovative approach for the assessment of REMS-based bone mineral density (BMD) of the axial skeleton. The principle of the REMS technology is based on the analysis of native raw unfiltered ultrasound signals during an echographic scan of the lumbar spine or the femoral neck [1]. Several studies demonstrated the high concordance with dual energy X-ray absorptiometry (DXA) in terms of measured BMD with this novel technology [2,3]. In previous published literature it was envisaged to apply this technology for the examination of the axial bone density in pregnant women. Pregnancy-associated bone loss has been demonstrated as decreased bone mineral density (BMD) in previous studies [4].Objectives:The aim of the current study is to compare the BMD values of both femora between pregnant and non-pregnant women matched for age and BMI using the novel REMS technology.Methods:Of total fifty women twenty pregnant women (40%) and thirty non-pregnant women (60%) were included in the study. The mean age of the pregnant women was 32 years ± 5 standard deviations (SD), (range 25-41 years) and the mean age of the non-pregnant women was 30 years ± 6 standard deviations (SD), (range 24-39 years). REMS approach was used to assess REMS-based BMD and REMS-based Z-score values of the femoral neck. Furthermore, body mass index (BMI) and gestational age in weeks were evaluated.Results:The mean BMI of the pregnant women was 26 kg/m2 ± 7 kg/m2 (range 14 kg/m2-42 kg/m2) and those of the non-pregnant women was 25 kg/m2 ± 5 kg/m2 (range 16 kg/m2-35 kg/m2). The mean gestational age was 20 weeks’ gestation ± 5 weeks’ gestation (range 13-27 weeks’ gestation). REMS-based mean BMD of the left femoral neck of the pregnant women was 0.793 g/cm2 ± 0.167 g/cm2 (range 0.563 g/cm2-1.154 g/cm2). REMS-based mean BMD of the right femoral neck of the pregnant women was 0.828 g/cm2 ± 0.153 g/cm2 (range 0.570 g/cm2-1.161 g/cm2). After comparing left femoral neck BMD with the right femoral neck BMD of the pregnant women, we found a linear correlation (R=0.764). Left femoral neck BMD value (0.793 g/cm2) of the pregnant women was significantly lower than those of the non-pregnant women (0.854 g/cm2), p=0.002. The mean left femoral Z-score of the pregnant women (-0.1 SD with range -2.5 SD-2.9 SD) was also significantly lower compared to those of the non-pregnant women (1.2 SD with range -1.5 SD-3.1 SD), p=0.003.Conclusion:This is the first study which provides data about BMD and Z-score values of both femora in pregnant women assessed with the radiation-free REMS technology. Pregnant women demonstrated significantly lower femoral neck BMD values and Z-scores compared to those of the non-pregnant women. Innovative REMS method could be very helpful for making decision about the treatment of pregnant women who are at risk of lower BMD due to concomitant diseases and/or treatment associated with osteoporosis.References:[1]Casciaro S, Conversano F, Pisani P, Muratore M. New perspectives in echographic diagnosis of osteoporosis on hip and spine. Clin Cases Miner Bone Metab. 2015; 12(2):142-150.[2]Nikolov M, Nikolov N. AB0908 Assessment of the impact of the lean mass with body composition by dual-energy x-ray absorptiometry on the bone mineral density. Annals of the Rheumatic Diseases 2020; 79:1756.[3]Chakova M., Chernev D., Kashukeeva P., Krustev P., Abedinov F. Lumbar Sympathectomy - Literature Review. International Journal of Science and Research (IJSR) Volume 7 Issue 8, August 2018 ISSN (Online): 2319-7064.[4]Degennaro, V. A.; Cagninelli, G.; Lombardi, F. A. “VP34.12: First assessment of maternal status during pregnancy by means of radiofrequency echographic multi-spectrometry technology”. Ultrasound in Obstetrics & Gynecology. 2020, 56 (S1): 199.Disclosure of Interests:None declared.

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