背景:本研究旨在探讨风湿性疾病患者不同阶段骨丢失的患病率以及潜在的危险因素。
方法:一项横断面研究招募了1398名风湿病患者和302名健康受试者。人口统计数据,血,收集骨矿物质密度(BMD)测试。采用logistic回归分析风湿性疾病患者骨丢失的危险因素。
结果:(1)风湿病患者包括40.0%的类风湿性关节炎(RA),14.7%系统性红斑狼疮(SLE),14.2%骨关节炎(OA),9.2%强直性脊柱病(AS),7.9%痛风,7.0%原发性干燥综合征(pSS),3.8%系统性硬化症(SSc),和3.2%的混合性结缔组织病(MCTD)。(2)50岁以下男性患者和绝经前女性患者,AS的骨密度评分(53.9%,P<0.001)和SLE(39.6%,P=0.034)患者低于健康对照组(18.2%)。(3)50岁及以上男性患者和绝经后女性RA患者骨质减少和骨质疏松的发生率较高(P<0.001)。OA(P=0.02)和SLE(P=0.011)高于健康者。(4)患有SLE的人,RA和AS获得“得分低于预期年龄范围”的最高奇数比率,骨质减少和骨质疏松症,分别。(5)年龄,女性,发现低BMI和维生素D缺乏与骨丢失呈负相关。血脂异常和高尿酸血症可能是保护因素。
结论:年轻的AS和SLE患者的骨丢失发生率明显增高,和老年RA患者,OA和SLE的患病率高于健康者。SLE,RA,SSc和AS在调整后发展成骨丢失的风险显著较高。年龄,在所有年龄分层的风湿病患者中,BMI和性别通常与骨丢失相关。这些发现与以前的研究没有明显不同。
BACKGROUND: This study is to explore the prevalence of different stages of bone loss and the potential risk factors in rheumatic patients.
METHODS: A cross-sectional study recruits 1398 rheumatic patients and 302 healthy subjects. Demographic data, blood, and bone mineral density (BMD) tests are collected. Risk factors for bone loss in rheumatic patients are analyzed by logistic regression.
RESULTS: (1) Rheumatic patients are consisted of 40.0% rheumatoid arthritis (RA), 14.7% systemic lupus erythematosus (SLE), 14.2% osteoarthritis (OA), 9.2% ankylosing spondylosis (AS), 7.9% gout, 7.0% primary Sjogren syndrome (pSS), 3.8% systemic sclerosis (SSc), and 3.2% mixed connective tissue disease (MCTD). (2) In male patients aged under 50 and premenopausal female patients, the bone mineral density score of AS (53.9%, P < 0.001) and SLE (39.6%, P = 0.034) patients is lower than the healthy controls (18.2%). (3) Osteopenia and osteoporosis are more prevailing in male patients aged or older than 50 and postmenopausal female patients with RA (P < 0.001), OA (P = 0.02) and SLE (P = 0.011) than healthy counterparts. (4) Those with SLE, RA and AS gain the highest odd ratio of \'score below the expected range for age\', osteopenia and osteoporosis, respectively. (5) Age, female, low BMI and hypovitaminosis D are found negatively associated with bone loss. Dyslipidemia and hyperuricemia could be protective factors.
CONCLUSIONS: Young patients with AS and SLE have a significant higher occurrence of bone loss, and older patients with RA, OA and SLE had higher prevalence than healthy counterparts. SLE, RA, SSc and AS were founded significant higher risks to develop into bone loss after adjustment. Age, BMI and gender were commonly-associated with bone loss in all age-stratified rheumatic patients. These findings were not markedly different from those of previous studies.