scholarly journals Study of local and generalized bone loss in patients with rheumatoid arthritis

2019 ◽  
Vol 57 (3) ◽  
pp. 328-332
Author(s):  
I. S. Dydykina ◽  
P. O. Kozhevnikova
Keyword(s):  
Rheumatoid Arthritis ◽  
Bone Mineral Density ◽  
Bone Loss ◽  
Chronic Inflammation ◽  
Bone Mineral ◽  
Mineral Density ◽  
Bone Changes ◽  
Hands And Feet ◽  
The Relationship ◽  
Peripheral Skeleton

Chronic inflammation in rheumatoid arthritis (RA) is accompanied by local (periarticular osteoporosis) and generalized loss of bone mineral density in the axial and peripheral skeleton. The paper discusses the relationship between local and generalized bone loss and the contribution of various factors to bone changes. Information about the contribution of age at the onset of RA to the progression of destructive changes in the hands and feet and the rate of generalized bone loss in the axial and peripheral skeleton are contradictory.

scholarly journals P129 Predictors of low bone mineral density in rheumatoid arthritis

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Malika A Swar ◽  
Marwan Bukhari
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Bone Mineral Density ◽  
Family History ◽  
Bone Loss ◽  
Femoral Neck ◽  
Bone Mineral ◽  
Fragility Fracture ◽  
Mineral Density ◽  
History Of

Abstract Background/Aims  Osteoporosis (OP) is an extra-articular manifestation of rheumatoid arthritis (RA) that leads to increased fracture susceptibility due to a variety of reasons including immobility and cytokine driven bone loss. Bone loss in other populations has well documented risk factors. It is unknown whether bone loss in RA predominantly affects the femoral neck or the spine. This study aimed to identify independent predictors of low bone mineral density (BMD) in patients RA at the lumbar spine and the femoral neck. Methods  This was a retrospective observational cohort study using patients with Rheumatoid arthritis attending for a regional dual X-ray absorptiometry (DEXA) scan at the Royal Lancaster Infirmary between 2004 and 2014. BMD in L1-L4 in the spine and in the femoral neck were recorded. The risk factors investigated were steroid use, family history of osteoporosis, smoking, alcohol abuse, BMI, gender, previous fragility fracture, number of FRAX(tm) risk factors and age. Univariate and Multivariate regression analysis models were fitted to explore bone loss at these sites using BMD in g/cm2 as a dependant variable. . Results  1,527 patients were included in the analysis, 1,207 (79%) were female. Mean age was 64.34 years (SD11.6). mean BMI was 27.32kg/cm2 (SD 5.570) 858 (56.2%) had some steroid exposure . 169(11.1%) had family history of osteoporosis. fragility fracture history found in 406 (26.6%). 621 (40.7%) were current or ex smokers . There was a median of 3 OP risk factors (IQR 1,3) The performance of the models is shown in table one below. Different risk factors appeared to influence the BMD at different sites and the cumulative risk factors influenced BMD in the spine. None of the traditional risk factors predicted poor bone loss well in this cohort. P129 Table 1:result of the regression modelsCharacteristicB femoral neck95% CIpB spine95%CIpAge at scan-0.004-0.005,-0.003<0.01-0.0005-0.002,0.00050.292Sex-0.094-0.113,-0.075<0.01-0.101-0.129,-0.072<0.01BMI (mg/m2)0.0080.008,0.0101<0.010.01130.019,0.013<0.01Fragility fracture-0.024-0.055,0.0060.12-0.0138-0.060,0.0320.559Smoking0.007-0.022,0.0350.650.0286-0.015,0.0720.20Alcohol0.011-0.033,0.0 5560.620.0544-0.013,0.1120.11Family history of OP0.012-0.021,0.0450.470.0158-0.034,0.0650.53Number of risk factors-0.015-0.039,0.0080.21-0.039-0.075,-0.0030.03steroids0.004-0.023,0.0320.030.027-0.015,0.0690.21 Conclusion  This study has shown that predictors of low BMD in the spine and hip are different and less influential than expected in this cohort with RA . As the FRAX(tm) tool only uses the femoral neck, this might underestimate the fracture risk in this population. Further work looking at individual areas is ongoing. Disclosure  M.A. Swar: None. M. Bukhari: None.

scholarly journals SAT0034 CLINICAL SIGNIFICANCE OF ANTI-CARBAMYLATED PROTEIN ANTIBODIES IN PREMENOPAUSAL RHEUMATOID ARTHRITIS WOMEN: RELATION TO DISEASE ACTIVITY AND BONE LOSS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 947.2-947
Author(s):  
R. Elnemr ◽  
R. Bastawy ◽  
R. Ghazala ◽  
M. Abdelrazek ◽  
N. Elsawy
Keyword(s):  
Rheumatoid Arthritis ◽  
Physical Activity ◽  
Bone Mineral Density ◽  
Body Mass Index ◽  
Serum Level ◽  
Bone Loss ◽  
Disease Activity ◽  
Bone Mineral ◽  
Mineral Density ◽  
Local Bone

Background:Anti carbamylated protein anti carP are present in patients with Rheumatoid Arthritis RA and are associated with erosions. However their association with systemic or local bone loss in RA patients is still not confirmed.Objectives:The purpose of this study was to measure the serum level of anti carP in premenopausal women with RA and determine its relation to disease activity and bone loss.Methods:This case control study was conducted on forty eight RA premenopausal female patients diagnosed according to 2010 ACR/EULAR criteria and forty eight ages and body mass index matched healthy premenopausal females. RA patients with other autoimmune diseases, viral hepatitis malignancy or erosive joint disease and systemic diseases that affect bone quality were excluded from the study. All RA women were subjected to history taking, clinical examination, assessment of disease activity using disease activity score-28 DAS28 and clinical disease activity index CDAI functional assessment using health assessment questionnaire HAQ physical activity assessment using international physical activity questionnaire short form IPAQ fatigue assessment using modified fatigue impact scale MFIS, routine laboratory investigations, serological tests as well as Anti carP using ELISA kit. Moreover the bone mineral density was measured by a lunar Prodigy Advanced DEXA scanner system and plain x-ray of both hands and wrists in the anteroposterior view was done to assess the juxta articular osteopenia and erosions.Results:Anti carP level was significantly higher in RA patients than in healthy controls table 1. The serum level of anti carP had a significant positive correlation with RA DAS, CDAI, HAQ, IPAQ, MFIS and erosion and joint space narrowing in original sharp score. Also the anti carP had a significant negative correlation with the bone mineral density BMD of spine. The AUC of anti carP level showed a high level of accuracy AUC 0.857 figure 1 and the calculated cutoff value >65 can precisely discriminate subjects with RA from those without RA with 85.42% sensitivity and 85.11% specificity.Table 1.Comparison between the patient and healthy groups according to anti carp levelAnti-carpRA patientsHealthy controlUpMin – Max15.0 – 90.01.0 – 78.50322.0*<0.001*Mean ± SD71.24 ± 14.7045.99 ± 21.99Median (IQR)72.75 (70.5–78.3)55.0 (32.5–61.5)Figure 1.ROC curve for anti carP to diagnose RA patients from healthy subjectsConclusion:Anti carbamylated antibodies were higher in premenopausal RA women compared to ages and body mass index matched healthy women. Anti carP are associated with higher RA disease activity, increased disability and decreased physical activity. Moreover anti carP are associated with systemic trabecular bone loss manifested by decreased bone mineral density of the spine as well as local bone loss as manifested by increased number of joint erosions in premenopausal RA women.References:[1] Regueiro C, Ortiz AM, Boveda MD, Castañeda S, Gonzalez-Alvaro I, Gonzalez A. Association of high titers of anti-carbamylated protein antibodies with decreased bone mineral density in early arthritis patients. PLoS ONE 2018; 13(8):e0202583.Disclosure of Interests:None declared

scholarly journals Time-averaged disease activity of rheumatoid arthritis associated with long-term bone mineral density changes

2020 ◽  
Vol 11 ◽  
pp. 204062232098151
Author(s):  
Chung-Yuan Hsu ◽  
Jia-Feng Chen ◽  
Yu-Jih Su ◽  
Ying-Chou Chen ◽  
Han-Ming Lai ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Bone Mineral Density ◽  
Bone Loss ◽  
Disease Activity ◽  
Bone Mineral ◽  
Osteoporosis Treatment ◽  
High Disease Activity ◽  
Mineral Density

Background: Rheumatoid arthritis (RA) is associated with poor bone mineral density (BMD). We designed the current study owing to the lack of long-term prospective studies regarding whether a high disease activity leads to increased bone loss. Methods: We have continually enrolled patients with RA. According to the average disease activity score in 28 joints based on the erythrocyte sedimentation rate (DAS28-ESR) during follow-up, the patients were classified into remission, low disease activity, and moderate or high disease activity groups. Patients were examined with dual-energy X-ray absorptiometry at baseline and after 3 years of follow-up. BMD changes were compared among the groups. Results: We have studied 477 patients. Overall BMD was significantly reduced from baseline to the 3-year follow-up ( p < 0.05). After stratifying according to the time-averaged DAS28-ESR levels and use of anti-osteoporosis treatment (AOT), the BMD values of the femur and spine significantly increased in patients in the remission group with AOT. The BMD changes of different DAS28-ESR patients were further compared using the generalized estimation equation model. For the patients on AOT, the negative change in femoral BMD values of the moderate or high activity group was significant when compared with the remission group with positive BMD changes (regression coefficient, –0.038; 95% confidence interval, –0.055 to –0.021). Conclusion: For RA patients, if remission is achieved, AOT can better improve BMD, especially in the femur. In addition, moderate or high disease activity will lead to significant bone loss; therefore, disease activity must be actively controlled.

scholarly journals Study of Correlation of Severity of Hepatic Cirrhosis with Severity of Bone Changes Measured by BMD (Bone Mineral Density)

2013 ◽  
Vol 22 (2) ◽  
pp. 41-46 ◽  
Author(s):  
Md Ashraful Alam ◽  
Nooruddin Ahmed ◽  
Sahinul Alam ◽  
Mamun Al Mahtab
Keyword(s):  
Bone Mineral Density ◽  
Liver Cirrhosis ◽  
Liver Disease ◽  
Bone Loss ◽  
Bone Mineral ◽  
Bone Disease ◽  
Liver Diseases ◽  
Hepatic Cirrhosis ◽  
Mineral Density ◽  
Bone Changes

Background & Aim Metabolic bone disease is common among patients with chronic liver disease and still it is underestimated complication in liver cirrhosis. The prevalence and presentation of bone disease in chronic liver diseases have been poorly described except for cholestatic liver diseases. This study aims at evaluation of the prevalence and degree of bone changes in patients with cirrhosis and to correlate severity of hepatic cirrhosis with the severity of bone changes. Patients and Methods Bone mineral density (BMD) was studied using dual energy X-ray absorptiometry (DEXA) in 60 subjects of 15-45 years old. Of them 30 subjects are patients with liver cirrhosis and rest of the 30 subjects were control group without having liver disease or any other chronic disease. The diagnosis of cirrhosis was based on clinical, biochemical, and ultrasonographic findings. Patients with renal impairment, cholestatic liver disease, chronic lung disease, prolonged bed ridden patients or deformity of spine, pelvis or wrist were excluded from the study. Results of BMD were then correlated with the Child score. Results Eighteen (60%) patients had decreased bone mineral density (BMD). Of which 15 (50%) patients have got osteopenia and 3 (10%) patients have got osteoporosis. No correlation was found between the T-score and Child Paugh score (p =0.236). Significant correlations were found between BMD and serum bilirubin. Conclusion Liver cirrhosis is a risk factor for the development of bone loss and there is a high prevalence of BMD disorders in cirrhotic patients. The severity of bone loss is not related to the severity of liver disease. Hyperbilirubinemia and low albumin is a contributing factor to altered bone mineral density in patients with liver cirrhosis DOI: http://dx.doi.org/10.3329/bjmed.v22i2.13588 Bangladesh J Medicine 2011; 22: 41-46

scholarly journals The Role of Autoimmunity on the Relation Between Erosions and Bone Mineral Density in Rheumatoid Arthritis: A Clinical Research

2021 ◽  
Author(s):  
Margaux Moret ◽  
Caroline Morizot ◽  
Marcelo de Carvalho Bittencourt ◽  
Edem Allado ◽  
Isabelle Chary-Valckenaere ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Bone Mineral Density ◽  
Bone Mineral ◽  
Mineral Density ◽  
T Score ◽  
Erosion Score ◽  
Pathway Activation ◽  
The Relationship ◽  
Acpa Status

Abstract IntroductionBoth erosions and osteoporosis are present in rheumatoid arthritis and are related to RANK-L pathway activation. The aim of the study was to evaluate the relationship between erosion and bone mineral density (BMD) in RA and whether it can be driven by autoimmunity.Patients and methodsPatients followed in the Department of Rheumatology between January 2008 and May 2019 satisfied the 1987 ACR or 2010 ACR-EULAR criteria. Erosions were evaluated by the modified Sharp/van der Heidje erosion score (SHSe) on radiographs and bone mineral density (BMD) in g/cm2 and by the T-score at the hip on DXA. The presence and titers of ACPA as well as rheumatoid factor (RF) and anti-nuclear antibodies (ANAs) were recorded at intervals of less than 2 years for both DXA and radiography.ResultsA total of 149 patients met the inclusion criteria. A total of 61.1% were ACPA positive, 79.9% were erosive and 10.7% had a hip T-score ≤-2.5. ACPA status but not titers was associated with a higher erosion score (63.0 (53.2) for ACPA + vs. 45.5 (44.1) for ACPA – (p= 0.04)). ACPA titers were associated with lower BMD at the hip (value -0.216; p=0.01) but not with T-score. A higher erosion score was associated with a lower BMD (R2: 0,049 and value: -0.222; p=0.009) and T-score (R2: 0,158 and value -0.397; p<0.0001) at the hip. In linear regression, erosion and systemic bone loss were still associated with but not driven by ACPA status or titer. RF and ANA did not demonstrate any role in this association.ConclusionWe showed that the relationship between erosion and bone mineral density associated with RA does not seem to be driven by ACPA or other autoimmunity parameters. However, the presence of ACPA or erosion should lead to osteoporosis assessment.

scholarly journals Accelerated hand bone mineral density loss is associated with progressive joint damage in hands and feet in recent-onset rheumatoid arthritis

2010 ◽  
Vol 12 (3) ◽  
pp. R96 ◽  
Author(s):  
Melek Güler-Yüksel ◽  
Naomi B Klarenbeek ◽  
Yvonne PM Goekoop-Ruiterman ◽  
Jeska K de Vries-Bouwstra ◽  
Sjoerd M van der Kooij ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Bone Mineral Density ◽  
Bone Mineral ◽  
Joint Damage ◽  
Mineral Density ◽  
Bone Mineral Density Loss ◽  
Recent Onset ◽  
Hands And Feet ◽  
Progressive Joint Damage
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