Relationship between physical disability, disease activity and osteoporosis in patients with rheumatoid arthritis

Amaç: Bu çalışma romatoid artrit (RA) tanısı konulmuş menopozlu hastalarda fiziksel engellilik, hastalık aktivitesinin derecesi ve kemik mineral yoğunluğu arasındaki ilişkiyi değerlendirmeyi amaçlamaktadır. Hastalar ve yöntemler: Çalışmaya menopoza erişmiş ve RA tanısı konulmuş 130 kadın (ort. yaş 62.77±7.51 yıl; dağılım 57-69 yıl) dahil edildi. Kemik mineral yoğunluğu dual enerji X-ray absorbsiyometri ile osteodansitometri yoluyla lomber omurga seviyesinde ve femurda (femur başı, tüm femur) .l.üldü. Romatoid artrit aktivitesini değerlendirmek için yaş, ağırlık, boy, vücut kütle indeksi, çevre (kentsel, kırsal), menarş ve menopoz başlangıç yaşı, menopoz süresi, sigara içme/içmeme durumu, RA aşaması, RA başlangıç yaşı, RA süresi, eklem dışı belirtiler, romatoid faktör varlığı, eritrosit sedimantasyon hızı, C reaktif protein, hastalık aktivite skoru 28 ve modifiye sağlık sorgulama anketi ile nicelenen fiziksel engellilik kullanıldı. Bulgular: Ortalama vücut kütle indeksi 27.74±4.37 kg/m2, ortalama menopoz süresi 16.42±8.15 yıl idi. Hastaların yaklaşık %44.62’sinde osteoporoz vardı. Osteoporoz sıklığı RA aşamasıyla arttı: aşama II’de %23.81, aşama III’te %55.0 ve aşama IV’te %77.78. Hastaların yaklaşık %58’i prednizon tedavisi g.rdü. Osteoporoz için bağımsız risk faktörleri şunlardı: yaş, çevre, vücut kütle indeksi, menopoz süresi, romatoid faktör varlığı ve eklem dışı belirtiler, RA süresi, modifiye sağlık sorgulama anketi, eritrosit sedimantasyon hızı ve C reaktif protein. Sonuç: Fiziksel engellilik ve hastalık aktivitesi RA tanısı konulmuş hastalarda osteoporoz gelişiminde rol oynamaktadır.

Romatoid artritli hastalarda fiziksel engellilik, hastalık aktivitesi ve osteoporoz arasındaki ilişki

Objectives: This study aims to assess the relationship between the physical disability, degree of disease activity, and bone mineral density in menopause patients diagnosed with rheumatoid arthritis (RA). Patients and methods: The study included 130 females (mean age 62.77±7.51 years; range 57 to 69 years) who reached menopause, and were diagnosed with RA. Bone mineral density was measured at the lumbar spine level and femur (femur head, entire femur) through osteodensitometry with dual X-ray absorptiometry. Age, weight, height, body mass index, environment (urban, rural), age of the menarche and the onset of menopause, duration of menopause, smoker/non-smoker status, RA stage, RA onset age, duration of RA, extra-articular manifestations, the presence of rheumatoid factor, erythrocyte sedimentation rate, C reactive protein, disease activity score 28, and physical disability quantified by modified health assessment questionnaire were used for evaluating the RA activity. Results: The mean body mass index was 27.74±4.37 kg/m2, the mean duration of menopause was 16.42±8.15 years. About 44.62% of the patients had osteoporosis. Osteoporosis frequency increased with RA stage: 23.81% in stage II, 55.0% in stage III, and 77.78% in stage IV. About 58% of the patients received prednisone treatment. Independent risk factors for osteoporosis were: age, environment, body mass index, duration of menopause, rheumatoid factor presence and extra-articular manifestations, duration of RA, modified health assessment questionnaire, erythrocyte sedimentation rate and C reactive protein. Conclusion: Physical disability and disease activity contribute to the occurrence of osteoporosis in patients diagnosed with RA.

Kaynakça

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2. Haugeberg G, Uhlig T, Falch JA, Halse JI, Kvien TK. 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 2000;43:522-30.

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14. Lodder MC, de Jong Z, Kostense PJ, Molenaar ET, Staal K, Voskuyl AE, et al. Bone mineral density in patients with rheumatoid arthritis: relation between disease severity and low bone mineral density. Ann Rheum Dis 2004;63:1576-80.

15. Haugeberg G, Uhlig T, Falch JA, Halse JI, Kvien TK. 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 2000;43:522-30.

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