Low Bone Mineral Density in Premenopausal Females with Rheumatoid Arthritis
Journal Title: International Journal of Contemporary Medical Research - Year 2018, Vol 5, Issue 8
Abstract
Introduction: Rheumatoid arthritis is known to negatively impact bone mineral density. This study aimed to evaluate prevalence and pattern of low bone mineral density in premenopausal females with rheumatoid arthritis. Material and Methods: In this prospective case control study, 113 premenopausal rheumatoid arthritis female patients were assessed and compared to 90 controls. Body mass index, co-morbidities, serum calcium, serum vitamin D and bone mineral density (using dual energy x ray absorptiometry) at lumbar spine (L1-L4), femur and radius were assessed in all subjects. Clinical disease activity index, erythrocyte sedimentation rate and c reactive protein were measured in all patients. Unpaired t test and Chi-square test/fisher exact test were used to analyze the data. Results: Low bone mineral density (Z-score ≤ -2) was significantly more prevalent in rheumatoid arthritis group as compared to controls (p=0.00019) especially at lower radius (p<0.0001). In rheumatoid arthritis patients, low bone mineral density was significantly more common in those with moderate to severe clinical disease activity, erosive disease and longer disease duration (p values 0.0200, <0.00001 and 0.00244 respectively). Conclusions: Premenopausal rheumatoid arthritis patients are susceptible for low bone mineral density especially at radius and more often if they have long standing, moderate to highly active and erosive disease. Early adequate treatment of rheumatoid arthritis along with monitoring of bone mineral density at wrist in these patients should be advised.
Authors and Affiliations
Urmila Dhakad, Meha Sharma, Rashmi Ranjan Sahoo, Siddharth Kumar Das, Bhupendra Pal Singh
Keywords
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