Risk factors associated with bone loss and occurrence of fragility fractures in rheumatoid arthritis patients

Publication date: Available online 13 February 2018Source: The Egyptian RheumatologistAuthor(s): Hamdi Wafa, Alaya Raja, Kaffel Dhia, Boughanmi Nada, Zouche Imene, Kchir Mohamed MontacerAbstractAim of the workTo investigate the bone mineral density (BMD) in rheumatoid arthritis (RA) Tunisian patients, to identify the risk factors associated with its decrease and to assess the fracture risk.Patients and methodsThe study included 173 patients and 173 matched healthy controls. BMD was assessed by the dual-energy X-ray absorptiometry. The risk of hip fracture (HF) and major osteoporotic fracture (MOF) were assessed using the fracture risk assessment tool (FRAX). The disease activity, radiological severity and functional status were investigated.ResultsThe mean age of patients was 54.1 ± 11.04 years and 141 were females; 71.6% menopausal. Disease duration was 8.2 ± 8 years and disease activity score was 5.54 ± 1.26. Sharp van-der-Heijde (SvdH) score was 113.9 ± 106.8, health assessment questionairre (HAQ) score 1.03 ± 0.9. The BMD was significantly reduced in 138 (79.8%) patients and FRAX was higher compared to control (p 
Source: The Egyptian Rheumatologist - Category: Rheumatology Source Type: research

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In conclusion, osteoporosis is prevalent among RA patients, as a part of a complex transformation of body mass composition, involving BMI and fat mass. The novel QUS scanning technique was able to replicate the results of the established DXA measurement of BMD and is potentially suitable for screening wide populations for osteoporosis. PMID: 31410123 [PubMed]
Source: Experimental and Therapeutic Medicine - Category: General Medicine Tags: Exp Ther Med Source Type: research
Conclusions The concept of osteoimmunology is aging well, almost 20 years since the term was coined. This way of interpreting bone and the immune system has been steadily providing new insights about how the two of them operate and cooperate. As an example, the role of pro-inflammatory cytokines in promoting osteoclastogenesis, and the many parallelisms between immune cells and osteoclasts have proved crucial to understand the biology of these giant bone-eating cells. Intriguingly, the control mechanisms between bone and the immune system are complex, tightly interconnected, and involve many players. The underlying comple...
Source: Frontiers in Endocrinology - Category: Endocrinology Source Type: research
Influence of Habitual Physical Behavior – Sleeping, Sedentarism, Physical Activity – On Bone Health in Community-Dwelling Older People Gladys Onambele-Pearson1*, Jorgen Wullems1,2, Conor Doody1, Declan Ryan1,3, Christopher Morse1 and Hans Degens4,5,6 1Department of Exercise and Sport Science, Manchester Metropolitan University, Manchester, United Kingdom 2Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium 3Faculty of Health and Society, University of Northampton, Northampton, United Kingdom 4School of Healthcare Science, Manchester Metropolitan University, Manchester, United Kingdom 5In...
Source: Frontiers in Physiology - Category: Physiology Source Type: research
Ryan R. Kelly1,2†, Lindsay T. McDonald1,2†, Nathaniel R. Jensen1,2, Sara J. Sidles1,2 and Amanda C. LaRue1,2* 1Research Services, Ralph H. Johnson VA Medical Center, Charleston, SC, United States 2Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, SC, United States The significant biochemical and physiological effects of psychological stress are beginning to be recognized as exacerbating common diseases, including osteoporosis. This review discusses the current evidence for psychological stress-associated mental health disorders as risk factors for os...
Source: Frontiers in Psychiatry - Category: Psychiatry Source Type: research
AbstractPurposeWe 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.MethodsFour 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.ResultsIn the RA affected female population, ~  80% suffered ...
Source: Archives of Orthopaedic and Trauma Surgery - Category: Orthopaedics Source Type: research
Authors: Nicolini A, Barbagelata E, Tagliabue E, Colombo D, Monacelli F, Braido F Abstract Chronic obstructive pulmonary disease (COPD) is generally considered to be prevalent in males. However, smoking is rising in women in developing and developed countries, while exposure to biomass fuel for domestic purposes is a recognized risk factor among females. Females developing more severe COPD patterns due to tobacco exposure than men maybe due to a genetic predisposition, a greater dose-dependent effect of smoke related to smaller airways caliber and an increased oxidative stress with augmented TGF-beta1 signaling. Ge...
Source: Panminerva Medica - Category: General Medicine Tags: Panminerva Med Source Type: research
Conclusion bone loss and fragility fracture are frequent in RA and related to disease severity, function impairment and corticosteroids use.
Source: The Egyptian Rheumatologist - Category: Rheumatology Source Type: research
This study had a cross-sectional design. Two hundred seventy-nine postmenopausal women with RA aged 50 years or older were included in this study. TBS measurements were performed on the same vertebrae as those for the BMD measurements. Among the 279 subjects, 34 had VFs (12.5%). There was a significant difference in the TBS (P = .005) but not L-spine BMD (P = .142) between the subjects with and those without VFs. The odds ratio (OR) for the TBS per standard deviation decrease was significant, even after adjusting for confounding factors such as age, height, rheumatoid factor positivity, the disease activity score ...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research
Conclusions: We conclude transvaginal estriol potentially offers a suitable physiologic delivery and cost-effective alternative to currently available estrogen regimens in selected patients. Additional studies on mode of delivery, safety, and efficacy merit further investigation.
Source: Menopause - Category: OBGYN Tags: Review Article Source Type: research
Fractures resulting from osteoporosis are a major public health problem. Physicians should be aware of the chief risk factors for osteoporosis and refer appropriately for bone densitometry. Risk factors include previous fracture, family history of fracture, slender habitus, early menopause, treatment with drugs known to affect bone (glucocorticoids) and diseases known to affect bone (rheumatoid arthritis). The diagnosis of osteoporosis can be made if the bone density T-score is −2.5 or below. This information can be used with other risk factors to estimate the 10-year risk of fractures.
Source: Medicine - Category: Internal Medicine Authors: Tags: Bone disorders Source Type: research
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