Clinical Study Of Bone Mineral Density And Bone Metabolism In Patients With Rheumatoid Arthritis

Objective:The aim of this study was to investigate the clinical factors of bone mineral density and bone metabolism in patients with rheumatoid arthritis(RA).Methods:Data were collected online from the clinical registry of Second Affiliated Hospital of Nanchang University,which is one of Chinese Rheumatism Data Centers.Among the RA patients in the CRDC who were recruited between April 2015 to February 2017.Only patients with BMD data,the X-ray examination and bone metabolism data available before the time of recruitment were included in this study.The baseline characteristics of patients in three groups(normal,osteopenia,and osteoporosis),defined by BMD results,were compared.Baseline characteristics included gender,age,age of onset,course of disease,menopausal status,number of joint with swelling and tenderness,use of glucocorticoid,serum calcium,serum phosphorus,ESR,CRP,DAS28,DAS44,SDAI,CDAI,RF titer,X-ray changes,anti CCP antibody titer,alkaline phosphatase,osteocalcin,parathyroid hormone 25-hydroxy vitamin D etc..All the data were analyzed by SPSS 20.0 for Windows statistical software.Results:1.A total of 81 RA patients met the criteria for admission.There were 16 males(19.8%)and 65 females(80.2%).Among the 81 patients with BMD data,35(43.2%),25(30.9%),and 21(25.9 %)patients were in the osteoporosis,osteopenia and normal groups,respectively.In addition,osteoporosis occurred in 39.5 % in the lumbar spine and 33.3 % in total hip.2.Significant improvement was seen in gender,age,menopausal status,blood Ca,25-hydroxy vitamin D in three groups(P<0.05).But disease activity-related factors such as DAS28,DAS44,SDAI,CDAI,ESR,CRP,number of joint with swelling and tenderness,BMI,disease duration,use of glucocorticoid,serum phosphorus,RF titer,anti CCP antibody titer,osteocalcin,alkaline phosphatase,parathyroid hormone did not differ among the three groups.3,The incidence of local bone damage in the three groups was gradually reduced,the highest in the OP group,but no statistical difference.Conclusion:Rheumatoid arthritis patients with osteoporosis can easily occur in the early stage of the disease,and the degree of osteoporosis is related to gender,age of onset,whether menopause,25-hydroxy vitamin D deficiency and so on.In patients with rheumatoid arthritis,especially in the elderly or menopausal women should be routinely screened for bone mineral density,early supplement of calcium.