Prevalence and risk factors for bone loss in rheumatoid arthritis patients from South China: modeled by three methods

Abstract

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.

Risk Factors Analysis of Bone Mineral Density Based on Lasso and Quantile Regression in America during 2015–2018

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Mechanisms of Systemic Osteoporosis in Rheumatoid Arthritis

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The prevalence of osteoporosis in rheumatoid arthritis patient: a systematic review and meta-analysis

“…Rheumatoid arthritis (RA) is one of the most common autoimmune diseases that in the early stages of the disease begins with pain and symmetrical swelling of the small joints of the hands, feet, swelling of the soft tissue around the joint and morning stiffness and fatigue 1 – 4 and it is characterized by persistent synovitis and progressive destruction of symmetrical multi-joints and intra-articular manifestations including subchondral lesions, decreased bone mass, and reduced generalized bone density 4 – 7 . The prevalence of RA in the general population is about 1%, but is more common in the 50 s and 60 s and is higher in women than men 8 , 9 .…”