| Objective: We explored the diagnostic significance of hand bone mineral density and the role it plays in the articular erosion in patients with rheumatoid arthritis (RA) . Furthermore , we evaluate several risk factors comprehensively combining with other laboratory and clinical markers.Method: (1) 46 patients with RA and population controls (n = 144) randomly selected after matching for age, sex, and weight were studied. Bone mineral density (BMD) were measured in hand,Lumbar spine,femur by dual energy x ray absorptiometry from RA patients and controls, and X ray of hand ,rheumatoid factor(RF),C reactive protein(CRP),erythrocyte sedimentation rate (ESR) were measured at the same time.(2) BMD of RA patients and controls were played in Tow-Sample T test.(3)We using the BMD in the rang of control quartiles were normal control rang, to lower the rang were masculine, to higher the rang were negative.(4) Diagnosing <2 year and controls were measured hand BMD, hand X ration , RF. We investigated the distribution of hand BMD, hand X ray , RF in patients of the two groups . A univariate analysis was used to determine whether hand BMD, hand X ray, RF plays a role on diagnose in RA. (5) Diagnosing >2 year and controls were measured hand BMD, RF, CRP, ESR, to determine which had the best predictive value for severe radiographic damage.Results: (1)Changes of Hand BMD is forgoing of the other body parts.(2)The sensitivity and of hand BMD, hand X ration, RF were61.5%,38.5%,53.8 %, the specificity is 80.7%,69.2%,71.1 %. When assayed together , these parameters would be changed if both markers were positive (hand BMD and RF , hand BMD and X ray of hand ) . (3) The positive rate of these four markers were much higher in group 2 than that in group 1 ,P<0.05.(4) Among these three markers , hand BMD had the highest positive predictive value ( 2.22 ) and OR ( 8.33 ) for articular erosion in RA. (5) Hand BMD had the strongest correlation with severe radiographic... |
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