Background To explore the prevalence of bone loss among patients with rheumatoid arthritis (RA) and healthy controls (HC) and further explored the risk factors for osteopenia and osteoporosis of RA patients. Methods A cross-sectional survey was undertaken in four hospitals in different districts in South China to reveal the prevalence of bone loss in patients. Case records, laboratory tests, and bone mineral density (BMD) results of patients were collected. Traditional multivariable logistic regression analysis and two machine learning methods, including least absolute shrinkage selection operator (LASSO) and random forest (RF) were for exploring the risk factors for osteopenia or osteoporosis in RA patients. Results Four hundred five patients with RA and 198 HC were included. RA patients had lower BMD in almost BMD measurement sites than healthy controls; the decline of lumbar spine BMD was earlier than HC. RA patients were more likely to comorbid with osteopenia and osteoporosis (p for trend < 0.001) in the lumbar spine than HC. Higher serum 25-hydroxyvitamin D3 level and using tumor necrosis factor inhibitor in the last year were protective factors; aging, lower body mass index, and increased serum uric acid might be risk factors for bone loss. Conclusions RA patients were more prone and earlier to have bone loss than HC. More attention should be paid to measuring BMD in RA patients aging with lower BMI or hyperuricemia. Besides, serum vitamin D and all three measurement sites are recommended to check routinely. TNFi usage in the last year might benefit bone mass.

Backgroud: This study is to explore the prevalence of different stages of bone loss and the potential risk factors in rheumatic patients. Method: A cross-sectional study recruits 1398 rheumatic patients and 302 healthy subjects. Demographic data, blood, and bone mineral density (BMD) tests are collected. Risk factors for bone loss in rheumatic patients are analyzed by logistic regression. Results: (1) Rheumatic patients are consisted of 40.0% rheumatoid arthritis (RA), 14.7% systemic lupus erythematosus (SLE), 14.2% osteoarthritis (OA), 9.2% ankylosing spondylosis (AS), 7.9% gout, 7.0% primary Sjogren syndrome (pSS), 3.8% systemic sclerosis (SSc), and 3.2% mixed connective tissue disease (MCTD). (2) In male patients aged under 50 and premenopausal female patients, the bone mineral density score of AS (53.9%, P < 0.001) and SLE (39.6%, P = 0.034) patients is lower than the healthy controls (18.2%). (3) Osteopenia and osteoporosis are more prevailing in male patients aged or older than 50 and postmenopausal female patients with RA (P < 0.001), OA (P = 0.02) and SLE (P = 0.011) than healthy counterparts. (4) Those with SLE, RA and AS gain the highest odd ratio of 'score below the expected range for age', osteopenia and osteoporosis, respectively. (5) Age, female, low BMI and hypovitaminosis D are found negatively associated with bone loss. Dyslipidemia and hyperuricemia could be protective factors. Conclusion: Young patients with AS and SLE have a significant higher occurrence of bone loss, and older patients with RA, OA and SLE had higher prevalence than healthy counterparts. SLE, RA, SSc and AS were founded significant higher risks to develop into bone loss after adjustment. Age, BMI and gender were commonly-associated with bone loss in all age-stratified rheumatic patients. These findings were not markedly different from those of previous studies.

Abstract Objectives: This study is to explore the prevalence of different stages of bone loss and the potential risk factors in rheumatic patients.Method: A cross-sectional study recruits 1,398 rheumatic patients and 302 healthy subjects. Demographic data, blood, and bone mineral density (BMD) tests are collected. Risk factors for bone loss in rheumatic patients are analyzed by logistic regression.Results: (1) Rheumatic patients are consisted of 40.0% rheumatoid arthritis (RA), 14.7% systemic lupus erythematosus (SLE), 14.2% osteoarthritis (OA), 9.2% ankylosing spondylosis (AS), 7.9% gout, 7.0% primary Sjogren syndrome (pSS), 3.8% systemic sclerosis (SSc), and 3.2% mixed connective tissue disease (MCTD). (2) In male patients aged under 50 and premenopausal female patients, the bone mineral density score of AS (53.9%, P<0.001) and SLE (39.6%, P=0.034) patients is lower than the healthy controls (18.2%). (3) Osteopenia and osteoporosis are more prevailing in male patients aged or older than 50 and postmenopausal female patients with RA (P<0.001), OA (P=0.02) and SLE (P =0.011) than healthy counterparts. (4) Those with SLE, RA and AS gain the highest odd ratio of ‘score below the expected range for age’, osteopenia and osteoporosis, respectively. (5) Age, female, low BMI and hypovitaminosis D are found negatively associated with bone loss. Dyslipidemia and hyperuricemia could be protective factors.Conclusion: Young patients with AS and SLE have a significant higher occurrence of bone loss, and older patients with RA, OA and SLE had higher prevalence than healthy counterparts. SLE, RA, SSc and AS were founded significant higher risks to develop into bone loss after adjustment. Age, BMI and gender were commonly-associated with bone loss in all age-stratified rheumatic patients. These findings were not markedly different from those of previous studies.

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Abstract Objectives: This study was to explore the prevalence of different severities of bone loss and the potential risk factors in rheumatic patients. Method: An analytical cross-sectional study design was performed. For the present study, 1,398 rheumatic patients and 302 healthy subjects were recruited and further accepted for data collection and blood and bone mineral density tests. Risk factors for bone loss in rheumatic patients were further analyzed by using multivariate logistic regression analysis. Results: (1) Rheumatic patients in this study are consisted of 40.0% rheumatoid arthritis, 14.7% systemic lupus erythematosus, 14.2% osteoarthritis, 9.2% ankylosing spondylosis, 7.9% gout, 7.0% primary Sjogren syndrome, 3.8% systemic sclerosis, and 3.2% mixed connective tissue disease. (2) In male patients aged under 50 and premenopausal female patients, the bone mineral density score of patients is lower than the healthy persons with the same gender and age (34.3% vs 18.2%， P =0.045). (3) Osteopenia and osteoporosis are more prevailing in male patients aged or older than 50 and postmenopausal female patients than healthy counterparts (92.7% vs 87.2%, P =0.017). (4) Regression analysis indicated that compared with a healthy population, those with systemic lupus erythematosus, rheumatoid arthritis and ankylosing spondylosis gained the highest odd ratio of ‘score below the expected range for age’, osteopenia and osteoporosis, respectively. (5) Hypovitaminosis D, ‘CRP elevated’ was commonly-associated with impaired bone mineral density in all rheumatic patients. Conclusion: Bone loss commonly occurs at any age in the setting of rheumatic diseases. Hypovitaminosis D, elevated CRP was probably commonly-associated with impaired BMD in all age groups of rheumatic patients.