高疾病活动与风湿性关节炎退伍军人中发生的骨质疏松性骨折有关
Katherine D Wysham1, Hannah F Brubeck2, Aaron Baraff2
1VA Puget Sound Health Care System, Seattle, WA, USA; University of Washington, Seattle, WA, USA; Puget Sound Geriatrics Research Education and Clinical Center, Seattle, WA, USA.
Joint bone spine
|December 19, 2025
概括
高风湿性关节炎 (RA) 疾病活动显著增加了退伍军人骨质疏松性骨折的风险. 保持低的RA疾病活性或缓解对于骨折预防至关重要.
科学领域:
- 类风湿病学 类风湿病学
- 骨质疏松症研究 骨质疏松症研究
- 临床流行病学临床流行病学
背景情况:
- 类风湿性关节炎 (RA) 是一种全身性自身免疫性疾病,与骨质疏松症和骨折风险增加有关.
- 关节炎炎症活动与骨质疏松性骨折发生率之间的确切关系需要进一步阐明.
研究的目的:
- 调查类风湿性关节炎疾病活动及其组成部分与发生骨质疏松性骨折风险之间的关联.
- 为了确定较高的RA疾病活性水平是否与经历骨折的可能性增加有关.
主要方法:
- 利用了来自多中心退伍军人事务局 (VARA) 登记处的数据.
- 采用多变量考克斯回归来分析随时间变化的和累积的RA疾病活性 (DAS28-ESR) 与发生的骨质疏松性骨折相关.
- 使用ICD9/10代码和图表审查验证的骨折识别;进行了敏感性分析,包括DAS28-ESR类别.
主要成果:
- 在2,912名退伍军人中,9%的人经历了骨质疏松性骨折事件.
- 增加的RA疾病活性与更高的骨折风险有关:随时间变化的DAS28-ESR每单位增加18%的风险增加 (aHR 1.18) 和每DAS28-ESR单位年3%的风险增加 (aHR 1.03).
- 中等和高的RA疾病活性 (DAS28-ESR) 与缓解相比,大约增加了骨折风险的2倍.
结论:
- 风湿性关节炎疾病活动的时间变化和累积测量都与发生骨质疏松性骨折的风险增加显著相关.
- 这些发现强调了在RA患者中实现和维持低疾病活性或缓解以减轻骨折风险的重要性.
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