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Impact of Bone Mineral Density and Bone Structural Properties on Postmenopausal Women With Rheumatoid Arthritis in Japan: A Cross-Sectional Study

  • 0Orthopedics, Tokushima Municipal Hospital, Tokushima, JPN.
Cureus +

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August 22, 2024

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August 22, 2024

View abstract on PubMed

Summary

This summary is machine-generated.

This study found that while bone mineral density (BMD) did not differ, Japanese postmenopausal women with rheumatoid arthritis (RA) on glucocorticoids (GCs) had lower trabecular bone score (TBS), indicating poorer bone structure.

Area Of Science

  • Rheumatology
  • Bone Metabolism
  • Geriatric Medicine

Background

  • Rheumatoid arthritis (RA) significantly impacts bone health, particularly in postmenopausal women.
  • Previous research has not specifically examined bone structural properties in Japanese postmenopausal women with RA.
  • Glucocorticoid (GC) use is common in RA management but is associated with bone loss.

Purpose Of The Study

  • To investigate bone mineral density (BMD) and bone structural properties in Japanese postmenopausal women with RA.
  • To compare bone health parameters between RA patients and a control group.
  • To assess the impact of glucocorticoid (GC) use on bone health in RA patients.

Main Methods

  • Cross-sectional study including 119 postmenopausal women with RA (symptoms >5 years) and 288 controls.
  • Dual-energy X-ray absorptiometry (DXA) scans were used to measure BMD, trabecular bone score (TBS), and hip structure analysis (HSA) parameters.
  • Propensity score matching was employed to control for age, BMI, and fracture history in group comparisons, including analysis of GC use within the RA cohort.

Main Results

  • No significant differences in BMD, TBS, or HSA parameters were found between the RA group and the control group after propensity score matching.
  • Within the RA group, patients receiving GCs exhibited a significantly lower TBS compared to those not on GCs (1.272 vs 1.313, p=0.008).
  • BMD and HSA parameters did not differ significantly between RA patients on GCs versus those not on GCs.

Conclusions

  • While overall BMD and hip structure were comparable between RA patients and controls, bone microarchitecture, as assessed by TBS, is affected in RA patients using GCs.
  • The findings highlight the importance of evaluating TBS in addition to BMD for assessing bone health in postmenopausal women with RA, especially those on GC therapy.
  • Clinicians managing RA patients with GCs should be vigilant about potential impacts on bone structure beyond traditional BMD measurements.

Keywords:

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