Hand bone mineral density is associated with both total hip and lumbar spine bone mineral density in post-menopausal women with RA
Department of Medicine, Division of Rheumatology
Medical Subject Headings
Absorptiometry, Photon; Age Factors; Aged; Arthritis, Rheumatoid; Bone Density; Cross-Sectional Studies; Epidemiologic Methods; Female; Hip Joint; Humans; Lumbar Vertebrae; Metacarpal Bones; Middle Aged; Postmenopause; Time Factors
Musculoskeletal Diseases | Rheumatology | Skin and Connective Tissue Diseases | Women's Health
OBJECTIVE: RA is associated with localized bone loss in the hands, as well as generalized osteoporosis. We evaluated the relationship between hand digital X-ray radiogrammetry BMD (DXR-BMD) and total hip and lumbar spine BMD.
METHODS: We conducted a cross-sectional study of 138 post-menopausal women with RA. The DXR-BMD was calculated based on digitized hand radiographs. Measurements of the total hip and lumbar spine BMD were performed by a DXA-BMD (BMDa) scan. Patient and physician questionnaires and laboratory samples supplied information on relevant covariates. Separate multivariate linear regression models were constructed to determine the cross-sectional relationship between hand DXR-BMD (independent variable) and total hip or lumbar spine BMD (dependent variables).
RESULTS: The cohort comprised women with a median age of 61 years and RA disease duration of 13 years. Seventy-six per cent were either RF and/or anti-cyclic citrullinated peptide (anti-CCP) positive and most had moderate disease activity [median disease activity score-28 joint count (DAS28) 3.7]. Hand DXR-BMD was significantly associated with total hip BMD (beta = 0.61; P < 0.0001) and lumbar spine BMD (beta = 0.62; P < 0.0008) in adjusted models.
CONCLUSIONS: This study suggests that hand DXR-BMD is associated with both the total hip and lumbar spine BMD among post-menopausal women with RA. The relationship between bone loss in the hands and generalized osteoporosis should be further explored in longitudinal studies of patients with RA.
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Citation: Rheumatology (Oxford). 2010 Mar;49(3):513-9. doi: 10.1093/rheumatology/kep385. Epub 2009 Dec 21. Link to article on publisher's site
Desai, Sonali P.; Gravallese, Ellen M.; Shadick, Nancy A.; Glass, Roberta; Cui, Jing; Frits, Michelle; Chibnik, Lori B.; Maher, Nancy; Weinblatt, Michael E.; and Solomon, Daniel H., "Hand bone mineral density is associated with both total hip and lumbar spine bone mineral density in post-menopausal women with RA" (2010). Rheumatology Publications and Presentations. 46.