Skip to main content
Erschienen in: Archives of Osteoporosis 1/2018

01.12.2018 | Original Article

An epidemiological analysis of osteoporotic characteristics in patients affected with rheumatoid arthritis in Kazakhstan

verfasst von: Gulzhan Gabdulina, Melody Kasher, Aliya Beissebayeva, Dana Mussabaeva, Alexander Tokarev, Gulmira Mominova, Gulnar Essirkepova, Ainash Amanzholova, Korlan Zaurbekova, Maira Saparbaeva, Maira Bizhanova, Moldir Kulshymanova, Gregory Livshits

Erschienen in: Archives of Osteoporosis | Ausgabe 1/2018

Einloggen, um Zugang zu erhalten

Abstract

Purpose

We aimed to assess which of the major risk factors associated with rheumatoid arthritis (RA) severity are also associated with osteoporosis-related phenotypes (OP-RP) in the native population of Kazakhstan.

Methods

Four hundred six RA patients (90.6% females) with 397 controls—unaffected first-degree relatives were recruited. Biochemical factors were recorded, and OP-RP were assessed using QCT scans and ultrasound densitometry (US) of the forearm to estimate cortical indices (CI), spongial bone mineral density (BMDSPN), and US_T-scores.

Results

In the RA affected female population, ~ 80% suffered from osteopenia or osteoporosis. All OP-RP were negatively correlated with age and female’s sex, as expected, and thus accordingly adjusted, resulting in consistent, significantly [p = 0.016 (CI), p < 0.0001 (both BMDSPN and US_T-scores)] lower OP-RP estimates in affected females. Using multiple regression analysis for OP-RP manifestations, only age and disease duration appeared consistently associated with all three studied phenotypes, while menopause status or years following the onset of menopause were also significant for BMDSPN and US_T-scores. However, when disease duration was examined, we found that it was significantly dependent on morning stiffness, ESR, total cholesterol levels, weight, and menopause status, which explains 38.6% of the disease duration.

Conclusions

Approximately 80% of female RA patients suffer from osteoporosis or osteopenia in the study group, which appears from a young age. RA disease duration is the major risk factor for OP-RP deterioration, especially as assessed by BMDSPNG, and US_T-scores. As a result, all OP-RP demonstrate significantly lower levels in comparison to sex- and age-matched unaffected individuals.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Silman AJ, Pearson JE (2002) Epidemiology and genetics of rheumatoid arthritis. Arthritis Res 4(Suppl 3):S265–S272CrossRef Silman AJ, Pearson JE (2002) Epidemiology and genetics of rheumatoid arthritis. Arthritis Res 4(Suppl 3):S265–S272CrossRef
2.
Zurück zum Zitat Choy EHS, Panayi GS (2001) Cytokine pathways and joint inflammation in rheumatoid arthritis. N Engl J Med 344(12):907–916CrossRef Choy EHS, Panayi GS (2001) Cytokine pathways and joint inflammation in rheumatoid arthritis. N Engl J Med 344(12):907–916CrossRef
3.
Zurück zum Zitat Gabriel SE (2001) The epidemiology of rheumatoid arthritis. Rheum Dis Clin N Am 27(2):269–281CrossRef Gabriel SE (2001) The epidemiology of rheumatoid arthritis. Rheum Dis Clin N Am 27(2):269–281CrossRef
4.
Zurück zum Zitat WHO (2016) WHO | Chronic rheumatic conditions WHO (2016) WHO | Chronic rheumatic conditions
5.
Zurück zum Zitat Chopra A, Abdel-Nasser A (2008) Epidemiology of rheumatic musculoskeletal disorders in the developing world. Best Pract Res Clin Rheumatol 22(4):583–604CrossRef Chopra A, Abdel-Nasser A (2008) Epidemiology of rheumatic musculoskeletal disorders in the developing world. Best Pract Res Clin Rheumatol 22(4):583–604CrossRef
6.
Zurück zum Zitat Weyand CM, Schmidt D, Wagner U, Goronzy JJ (1998) The influence of sex on the phenotype of rheumatoid arthritis. Arthritis Rheum 41(5):817–822CrossRef Weyand CM, Schmidt D, Wagner U, Goronzy JJ (1998) The influence of sex on the phenotype of rheumatoid arthritis. Arthritis Rheum 41(5):817–822CrossRef
7.
Zurück zum Zitat Sokka T et al (2009) Women, men, and rheumatoid arthritis: analyses of disease activity, disease characteristics, and treatments in the QUEST-RA study. Arthritis Res Ther 11(1):R7PubMedPubMedCentral Sokka T et al (2009) Women, men, and rheumatoid arthritis: analyses of disease activity, disease characteristics, and treatments in the QUEST-RA study. Arthritis Res Ther 11(1):R7PubMedPubMedCentral
8.
Zurück zum Zitat Hauser B, Riches PL, Wilson JF, Horne AE, Ralston SH (2014) Prevalence and clinical prediction of osteoporosis in a contemporary cohort of patients with rheumatoid arthritis. Rheumatology 53(10):1759–1766CrossRef Hauser B, Riches PL, Wilson JF, Horne AE, Ralston SH (2014) Prevalence and clinical prediction of osteoporosis in a contemporary cohort of patients with rheumatoid arthritis. Rheumatology 53(10):1759–1766CrossRef
9.
Zurück zum Zitat Lee J-H et al (2016) The frequency of and risk factors for osteoporosis in Korean patients with rheumatoid arthritis. BMC Musculoskelet Disord 17(1):98CrossRef Lee J-H et al (2016) The frequency of and risk factors for osteoporosis in Korean patients with rheumatoid arthritis. BMC Musculoskelet Disord 17(1):98CrossRef
10.
Zurück zum Zitat Mobini M, Kashi Z, Ghobadifar A (2012) Prevalence and associated factors of osteoporosis in female patients with rheumatoid arthritis. Casp J Intern Med 3(3):447–450 Mobini M, Kashi Z, Ghobadifar A (2012) Prevalence and associated factors of osteoporosis in female patients with rheumatoid arthritis. Casp J Intern Med 3(3):447–450
11.
Zurück zum Zitat Haugeberg G, Uhlig T, Falch JA, Halse JI, Kvien TK (2000) Bone mineral density and frequency of osteoporosis in female patients with rheumatoid arthritis: results from 394 patients in the Oslo County rheumatoid arthritis register. Arthritis Rheum 43(3):522CrossRef Haugeberg G, Uhlig T, Falch JA, Halse JI, Kvien TK (2000) Bone mineral density and frequency of osteoporosis in female patients with rheumatoid arthritis: results from 394 patients in the Oslo County rheumatoid arthritis register. Arthritis Rheum 43(3):522CrossRef
13.
Zurück zum Zitat Sapir-Koren R, Livshits G (2017) Postmenopausal osteoporosis in rheumatoid arthritis: the estrogen deficiency-immune mechanisms link. Bone 103:102–115CrossRef Sapir-Koren R, Livshits G (2017) Postmenopausal osteoporosis in rheumatoid arthritis: the estrogen deficiency-immune mechanisms link. Bone 103:102–115CrossRef
14.
Zurück zum Zitat Wasserman AM (2011) Diagnosis and management of rheumatoid arthritis. Am Fam Physician 84(11):1245–52 Wasserman AM (2011) Diagnosis and management of rheumatoid arthritis. Am Fam Physician 84(11):1245–52
15.
Zurück zum Zitat Abdulameer SA, Sahib MN, Sulaiman SAS (2018) The Prevalence of osteopenia and osteoporosis among Malaysian type 2 diabetic patients using quantitative ultrasound densitometer. Open Rheumatol J 12:50–64CrossRef Abdulameer SA, Sahib MN, Sulaiman SAS (2018) The Prevalence of osteopenia and osteoporosis among Malaysian type 2 diabetic patients using quantitative ultrasound densitometer. Open Rheumatol J 12:50–64CrossRef
16.
Zurück zum Zitat Blake GM, Fogelman I (2007) The role of DXA bone density scans in the diagnosis and treatment of osteoporosis. Postgrad Med J 83(982):509–517CrossRef Blake GM, Fogelman I (2007) The role of DXA bone density scans in the diagnosis and treatment of osteoporosis. Postgrad Med J 83(982):509–517CrossRef
17.
Zurück zum Zitat Adams JE (2009) Quantitative computed tomography. Eur J Radiol 71(3):415–424CrossRef Adams JE (2009) Quantitative computed tomography. Eur J Radiol 71(3):415–424CrossRef
18.
Zurück zum Zitat Li N, Li X-M, Xu L, Sun W-J, Cheng X-G, Tian W (2013) Comparison of QCT and DXA: osteoporosis detection rates in postmenopausal women. Int J Endocrinol 2013:895474PubMedPubMedCentral Li N, Li X-M, Xu L, Sun W-J, Cheng X-G, Tian W (2013) Comparison of QCT and DXA: osteoporosis detection rates in postmenopausal women. Int J Endocrinol 2013:895474PubMedPubMedCentral
19.
Zurück zum Zitat Sokka T, Pincus T (2009) Erythrocyte sedimentation rate, C-reactive protein, or rheumatoid factor are normal at presentation in 35%–45% of patients with rheumatoid arthritis seen between 1980 and 2004: analyses from Finland and the United States. J Rheumatol 36(7):1387–1390. https://doi.org/10.3899/jrheum.080770 CrossRefPubMed Sokka T, Pincus T (2009) Erythrocyte sedimentation rate, C-reactive protein, or rheumatoid factor are normal at presentation in 35%–45% of patients with rheumatoid arthritis seen between 1980 and 2004: analyses from Finland and the United States. J Rheumatol 36(7):1387–1390. https://​doi.​org/​10.​3899/​jrheum.​080770 CrossRefPubMed
20.
Zurück zum Zitat Pi H, Zhou H, Jin H, Ning Y, Wang Y (2017) Abnormal glucose metabolism in rheumatoid arthritis. Biomed Res Int 2017:9670434CrossRef Pi H, Zhou H, Jin H, Ning Y, Wang Y (2017) Abnormal glucose metabolism in rheumatoid arthritis. Biomed Res Int 2017:9670434CrossRef
21.
Zurück zum Zitat Rajput R, Dangi A, Singh H (2017) Prevalence of glucose intolerance in rheumatoid arthritis patients at a tertiary care centre in Haryana. Diabetes Metab Syndr Clin Res Rev 11:S1013–S1016CrossRef Rajput R, Dangi A, Singh H (2017) Prevalence of glucose intolerance in rheumatoid arthritis patients at a tertiary care centre in Haryana. Diabetes Metab Syndr Clin Res Rev 11:S1013–S1016CrossRef
22.
Zurück zum Zitat Pincus T, Sokka T Laboratory tests to assess patients with rheumatoid arthritis: advantages and limitations. Rheum Dis Clin N Am 35(4):731–734CrossRef Pincus T, Sokka T Laboratory tests to assess patients with rheumatoid arthritis: advantages and limitations. Rheum Dis Clin N Am 35(4):731–734CrossRef
23.
Zurück zum Zitat Ursum J, Bos WH, van de Stadt RJ, Dijkmans BAC, van Schaardenburg D (2009) Different properties of ACPA and IgM-RF derived from a large dataset: further evidence of two distinct autoantibody systems. Arthritis Res Ther 11(3):R75CrossRef Ursum J, Bos WH, van de Stadt RJ, Dijkmans BAC, van Schaardenburg D (2009) Different properties of ACPA and IgM-RF derived from a large dataset: further evidence of two distinct autoantibody systems. Arthritis Res Ther 11(3):R75CrossRef
24.
Zurück zum Zitat Hernlund E et al (2013) Osteoporosis in the European Union: medical management, epidemiology and economic burden. A report prepared in collaboration with the International Osteoporosis Foundation (IOF) and the European Federation of Pharmaceutical Industry Associations (EFPIA). Arch Osteoporos 8(1–2):136CrossRef Hernlund E et al (2013) Osteoporosis in the European Union: medical management, epidemiology and economic burden. A report prepared in collaboration with the International Osteoporosis Foundation (IOF) and the European Federation of Pharmaceutical Industry Associations (EFPIA). Arch Osteoporos 8(1–2):136CrossRef
25.
Zurück zum Zitat Kocijan R, Finzel S, Englbrecht M, Engelke K, Rech J, Schett G (2014) Decreased quantity and quality of the periarticular and nonperiarticular bone in patients with rheumatoid arthritis: a cross-sectional HR-pQCT study. J Bone Miner Res 29(4):1005–1014CrossRef Kocijan R, Finzel S, Englbrecht M, Engelke K, Rech J, Schett G (2014) Decreased quantity and quality of the periarticular and nonperiarticular bone in patients with rheumatoid arthritis: a cross-sectional HR-pQCT study. J Bone Miner Res 29(4):1005–1014CrossRef
26.
Zurück zum Zitat Moula K, Esfehani A (2002) A study of the bone density of rheumatoid arthritis patients in khoozestan province. J Shaheed Sadoughi Univ Med Sci 3:8–12 Moula K, Esfehani A (2002) A study of the bone density of rheumatoid arthritis patients in khoozestan province. J Shaheed Sadoughi Univ Med Sci 3:8–12
27.
Zurück zum Zitat Piotr Leszczyński SM, Hrycaj P (2007) Osteoporoza u chorych na reumatoidalne zapalenie stawów – realny problem czy fikcja? Ocena występowania złamań trzonów kręgowych u kobiet z reumatoidalnym zapaleniem stawów w wieku do 50 lat. Reumatologia/Rheumatology 45(6):362–368 Piotr Leszczyński SM, Hrycaj P (2007) Osteoporoza u chorych na reumatoidalne zapalenie stawów – realny problem czy fikcja? Ocena występowania złamań trzonów kręgowych u kobiet z reumatoidalnym zapaleniem stawów w wieku do 50 lat. Reumatologia/Rheumatology 45(6):362–368
28.
Zurück zum Zitat Xu S, Wang Y, Lu J, Xu J (2012) Osteoprotegerin and RANKL in the pathogenesis of rheumatoid arthritis-induced osteoporosis. Rheumatol Int 32(11):3397–3403CrossRef Xu S, Wang Y, Lu J, Xu J (2012) Osteoprotegerin and RANKL in the pathogenesis of rheumatoid arthritis-induced osteoporosis. Rheumatol Int 32(11):3397–3403CrossRef
29.
Zurück zum Zitat Gonzalez-Lopez L et al (2012) Performance of risk indices for identifying low bone mineral density and osteoporosis in Mexican Mestizo women with rheumatoid arthritis. J Rheumatol 39(2):247–253CrossRef Gonzalez-Lopez L et al (2012) Performance of risk indices for identifying low bone mineral density and osteoporosis in Mexican Mestizo women with rheumatoid arthritis. J Rheumatol 39(2):247–253CrossRef
30.
Zurück zum Zitat Aeberli D et al (2010) Reduced trabecular bone mineral density and cortical thickness accompanied by increased outer bone circumference in metacarpal bone of rheumatoid arthritis patients: a cross-sectional study. Arthritis Res Ther 12(3):R119CrossRef Aeberli D et al (2010) Reduced trabecular bone mineral density and cortical thickness accompanied by increased outer bone circumference in metacarpal bone of rheumatoid arthritis patients: a cross-sectional study. Arthritis Res Ther 12(3):R119CrossRef
31.
Zurück zum Zitat Jensen T et al (2004) Bone loss in unclassified polyarthritis and early rheumatoid arthritis is better detected by digital x ray radiogrammetry than dual x ray absorptiometry: relationship with disease activity and radiographic outcome. Ann Rheum Dis 63(1):15–22CrossRef Jensen T et al (2004) Bone loss in unclassified polyarthritis and early rheumatoid arthritis is better detected by digital x ray radiogrammetry than dual x ray absorptiometry: relationship with disease activity and radiographic outcome. Ann Rheum Dis 63(1):15–22CrossRef
32.
Zurück zum Zitat Eser P, Aeberli D, Widmer J, Ller BM, Villiger PM Abnormal bone geometry at the metacarpal bone shaft of rheumatoid arthritis patients with maintained muscle–bone relationship. Arthritis Care Res 63:383–389. https://doi.org/10.1002/acr.20394 Eser P, Aeberli D, Widmer J, Ller BM, Villiger PM Abnormal bone geometry at the metacarpal bone shaft of rheumatoid arthritis patients with maintained muscle–bone relationship. Arthritis Care Res 63:383–389. https://​doi.​org/​10.​1002/​acr.​20394
33.
Zurück zum Zitat Keller C, Hafström I, Svensson B (2001) Scandinavian Journal of Rheumatology Bone mineral density in women and men with early rheumatoid arthritis. Ingia Èld Hafstro Èm 2 , and Bjo Èrn Svensson 1 for the BARFOT study group #. Scand J Rheumatol 30:213–20 Keller C, Hafström I, Svensson B (2001) Scandinavian Journal of Rheumatology Bone mineral density in women and men with early rheumatoid arthritis. Ingia Èld Hafstro Èm 2 , and Bjo Èrn Svensson 1 for the BARFOT study group #. Scand J Rheumatol 30:213–20
34.
Zurück zum Zitat Lane NE, Pressman AR, Star VL, Cummings SR, Nevitt MC (Dec. 2009) Rheumatoid arthritis and bone mineral density in elderly women. J Bone Miner Res 10(2):257–263CrossRef Lane NE, Pressman AR, Star VL, Cummings SR, Nevitt MC (Dec. 2009) Rheumatoid arthritis and bone mineral density in elderly women. J Bone Miner Res 10(2):257–263CrossRef
35.
Zurück zum Zitat Hafez EA, Mansour HE, Hamza SH, Moftah SG, Younes TB, Ismail MA (2011) Bone mineral density changes in patients with recent-onset rheumatoid arthritis. Clin Med Insights Arthritis Musculoskelet Disord 4:87–94CrossRef Hafez EA, Mansour HE, Hamza SH, Moftah SG, Younes TB, Ismail MA (2011) Bone mineral density changes in patients with recent-onset rheumatoid arthritis. Clin Med Insights Arthritis Musculoskelet Disord 4:87–94CrossRef
37.
Zurück zum Zitat Karlsson MK, Gardsell P, Johnell O, Nilsson E, Akesson K, Obrant KJ (1993) Bone mineral normative data in Malmo, Sweden comparison with reference data and hip fracture incidence in other ethnic groups. Acta Orthop Scand 64(2):168–161CrossRef Karlsson MK, Gardsell P, Johnell O, Nilsson E, Akesson K, Obrant KJ (1993) Bone mineral normative data in Malmo, Sweden comparison with reference data and hip fracture incidence in other ethnic groups. Acta Orthop Scand 64(2):168–161CrossRef
38.
Zurück zum Zitat Laan RF et al (1993) Bone mineral density in patients with recent onset rheumatoid arthritis: influence of disease activity and functional capacity. Ann Rheum Dis 52(52):21–26CrossRef Laan RF et al (1993) Bone mineral density in patients with recent onset rheumatoid arthritis: influence of disease activity and functional capacity. Ann Rheum Dis 52(52):21–26CrossRef
39.
Zurück zum Zitat Gough AK, Lilley J, Eyre S, Holder RL, Emery P (1994) Generalised bone loss in patients with early rheumatoid arthritis. Lancet 344(8914):23–27CrossRef Gough AK, Lilley J, Eyre S, Holder RL, Emery P (1994) Generalised bone loss in patients with early rheumatoid arthritis. Lancet 344(8914):23–27CrossRef
40.
Zurück zum Zitat Kroger H, Honkanen R, Saarikoski S, Alhava E (1994) Decreased axial bone mineral density in perimenopausal women with rheumatoid arthritis-a population based study. Ann Rheum Dis 53:18–23CrossRef Kroger H, Honkanen R, Saarikoski S, Alhava E (1994) Decreased axial bone mineral density in perimenopausal women with rheumatoid arthritis-a population based study. Ann Rheum Dis 53:18–23CrossRef
41.
Zurück zum Zitat Myasoedova E, Crowson CS, Kremers HM, Fitz-Gibbon PD, Therneau TM, Gabriel SE (2010) Total cholesterol and LDL levels decrease before rheumatoid arthritis. Ann Rheum Dis 69(7):1310–1314CrossRef Myasoedova E, Crowson CS, Kremers HM, Fitz-Gibbon PD, Therneau TM, Gabriel SE (2010) Total cholesterol and LDL levels decrease before rheumatoid arthritis. Ann Rheum Dis 69(7):1310–1314CrossRef
Metadaten
Titel
An epidemiological analysis of osteoporotic characteristics in patients affected with rheumatoid arthritis in Kazakhstan
verfasst von
Gulzhan Gabdulina
Melody Kasher
Aliya Beissebayeva
Dana Mussabaeva
Alexander Tokarev
Gulmira Mominova
Gulnar Essirkepova
Ainash Amanzholova
Korlan Zaurbekova
Maira Saparbaeva
Maira Bizhanova
Moldir Kulshymanova
Gregory Livshits
Publikationsdatum
01.12.2018
Verlag
Springer London
Erschienen in
Archives of Osteoporosis / Ausgabe 1/2018
Print ISSN: 1862-3522
Elektronische ISSN: 1862-3514
DOI
https://doi.org/10.1007/s11657-018-0514-9

Weitere Artikel der Ausgabe 1/2018

Archives of Osteoporosis 1/2018 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.