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Risk of Osteoporosis and Degraded Trabecular Bone Score in Rheumatoid Arthritis Patients
Huong Nguyen1,2, Cong Minh Doan1,3, Karen Hind4
1Rheumatology Department, Nguyen Tri Phuong Hospital, Ho Chi Minh City, Vietnam.
International Journal of Rheumatic Diseases
|December 8, 2025
Summary
Rheumatoid arthritis patients face higher osteoporosis risks. Advanced age, low body weight, and sarcopenia are linked to osteoporosis, while older age and RA-related bone damage correlate with degraded trabecular bone score (TBS).
Area of Science:
- Rheumatology
- Bone Metabolism
- Osteoporosis Research
Background:
- Rheumatoid arthritis (RA) patients have an elevated risk of osteoporosis and fractures, especially with glucocorticoid treatment.
- Trabecular bone score (TBS) assesses bone microarchitecture, improving fracture risk prediction beyond bone mineral density (BMD).
Purpose of the Study:
- To identify factors associated with osteoporosis and degraded TBS in rheumatoid arthritis (RA) patients.
- To analyze general and RA-specific risk factors for bone health in RA patients.
Main Methods:
- A cross-sectional study of 131 RA patients evaluated BMD and TBS using Asian reference standards.
- Osteoporosis was defined by WHO criteria (T-score ≤ -2.5); degraded TBS was defined as < 1.23.
- Multivariate logistic regression analyzed factors associated with osteoporosis and degraded TBS.
Main Results:
- 22.1% of RA patients had osteoporosis, and 26% had degraded TBS.
- Osteoporosis was associated with advanced age, lower body weight, and sarcopenia.
- Degraded TBS was linked to older age and structural RA-associated bone damage.
Conclusions:
- Advanced age, low body weight, and sarcopenia are key factors for osteoporosis in RA.
- Older age and RA-associated structural damage are associated with degraded TBS.
- Combining BMD and TBS is recommended for comprehensive bone health assessment in RA patients.
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