The frequency of and risk factors for osteoporosis in Korean patients with rheumatoid arthritis

Joo Hyun Lee; Yoon Kyoung Sung; Chan Bum Choi; Soo Kyung Cho; So Young Bang; Jung Yoon Choe; Seung Jae Hong; Jae Bum Jun; Tae Hwan Kim; Jisoo Lee; Hye Soon Lee; Dae Hyun Yoo; Bo Young Yoon; Sang Cheol Bae

doi:10.1186/s12891-016-0952-8

The frequency of and risk factors for osteoporosis in Korean patients with rheumatoid arthritis

Joo Hyun Lee, Yoon Kyoung Sung, Chan Bum Choi, Soo Kyung Cho, So Young Bang, Jung Yoon Choe, Seung Jae Hong, Jae Bum Jun, Tae Hwan Kim, Jisoo Lee, Hye Soon Lee, Dae Hyun Yoo, Bo Young Yoon, Sang Cheol Bae

Department of Internal Medicine

Research output: Contribution to journal › Article › peer-review

39 Scopus citations

Abstract

Background: The aim of this study was to investigate the prevalence of osteoporosis in rheumatoid arthritis (RA) patients and to analyze the risk factors in these patients using the KORean Observational study Network for Arthritis (KORONA) database. Methods: Among the RA patients in the KORONA who were recruited between July 2009 and December 2011, postmenopausal women with bone mineral density (BMD) results within one year from the time of KORONA enrollment were included in this study. The baseline characteristics of patients in three groups, defined by BMD results, were compared. The BMD measurement rates and prevalence of osteoporosis in the study patients were calculated in accordance with age and gender subgroups. Multivariable logistic regression analysis was used to explore the association between osteoporosis and demographics and disease-related risk factors. Results: Of 1322 postmenopausal woman patients with RA in whom BMD was measured within one year of study enrollment, 619 patients (46.8 %) were in the osteoporosis group (T-score ≤ -2.5 SD). RA patients with osteoporosis had a higher frequency of previous fractures than those in other groups, especially fractures of the femur (p = 0.004) and wrist (p = 0.042). Advanced age (≥70 years; OR = 2.28, 95 % CI: 1.40-3.58), lower body mass index (<25; OR = 2.14, 95 % CI:1.52-3.02), longer disease duration (≥10 years; OR = 1.46, 95 % CI: 1.07-2.00), higher cumulative glucocorticoid dose (OR = 1.03, 95 % CI: 1.01-1.05), and higher Health Assessment Questionnaire score (OR = 1.37, 95 % CI:1.11-1.69) were independent risk factors for osteoporosis. Conclusion: A large percentage (90.8 %) of RA patients enrolled in the KORONA cohort had osteoporosis and osteopenia. Nevertheless, BMD measurement rates in this population remained low, despite high risk groups of fractures.

Original language	English
Article number	98
Journal	BMC Musculoskeletal Disorders
Volume	17
Issue number	1
DOIs	https://doi.org/10.1186/s12891-016-0952-8
State	Published - 24 Feb 2016

Bibliographical note

Funding Information:
KORONA was established in July 2009 by the Clinical Research Center for Rheumatoid Arthritis and funded by the Ministry of Health and Affairs, South Korea. RA patients over the age of 18 who satisfied the 1987 American College of Rheumatology (ACR) classification criteria for RA [13] were recruited by rheumatologists from 23 centers across South Korea as part of KORONA. Among those patients, only postmenopausal women were enrolled in this study. A total of 3531 patients with RA were recruited between July 2009 and December 2011, and 1322 postmenopausal women whose BMD examination results were available within one year from the time of KORONA enrollment were included in this study (Fig. 1). The KORONA protocol was approved by the institutional review boards of Hanyang University Hospital and all participating hospitals, and informed consent was obtained from all patients before registration.

Funding Information:
This study was supported by a grant of the Korea Healthcare technology R&D Project, Ministry of Health and Welfare, Republic of Korea (A102065).

Publisher Copyright:
© 2016 Lee et al.

Keywords

Frequency
Osteoporosis
Rheumatoid arthritis
Risk factors

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10.1186/s12891-016-0952-8

Cite this

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title = "The frequency of and risk factors for osteoporosis in Korean patients with rheumatoid arthritis",

abstract = "Background: The aim of this study was to investigate the prevalence of osteoporosis in rheumatoid arthritis (RA) patients and to analyze the risk factors in these patients using the KORean Observational study Network for Arthritis (KORONA) database. Methods: Among the RA patients in the KORONA who were recruited between July 2009 and December 2011, postmenopausal women with bone mineral density (BMD) results within one year from the time of KORONA enrollment were included in this study. The baseline characteristics of patients in three groups, defined by BMD results, were compared. The BMD measurement rates and prevalence of osteoporosis in the study patients were calculated in accordance with age and gender subgroups. Multivariable logistic regression analysis was used to explore the association between osteoporosis and demographics and disease-related risk factors. Results: Of 1322 postmenopausal woman patients with RA in whom BMD was measured within one year of study enrollment, 619 patients (46.8 %) were in the osteoporosis group (T-score ≤ -2.5 SD). RA patients with osteoporosis had a higher frequency of previous fractures than those in other groups, especially fractures of the femur (p = 0.004) and wrist (p = 0.042). Advanced age (≥70 years; OR = 2.28, 95 % CI: 1.40-3.58), lower body mass index (<25; OR = 2.14, 95 % CI:1.52-3.02), longer disease duration (≥10 years; OR = 1.46, 95 % CI: 1.07-2.00), higher cumulative glucocorticoid dose (OR = 1.03, 95 % CI: 1.01-1.05), and higher Health Assessment Questionnaire score (OR = 1.37, 95 % CI:1.11-1.69) were independent risk factors for osteoporosis. Conclusion: A large percentage (90.8 %) of RA patients enrolled in the KORONA cohort had osteoporosis and osteopenia. Nevertheless, BMD measurement rates in this population remained low, despite high risk groups of fractures.",

keywords = "Frequency, Osteoporosis, Rheumatoid arthritis, Risk factors",

author = "Lee, {Joo Hyun} and Sung, {Yoon Kyoung} and Choi, {Chan Bum} and Cho, {Soo Kyung} and Bang, {So Young} and Choe, {Jung Yoon} and Hong, {Seung Jae} and Jun, {Jae Bum} and Kim, {Tae Hwan} and Jisoo Lee and Lee, {Hye Soon} and Yoo, {Dae Hyun} and Yoon, {Bo Young} and Bae, {Sang Cheol}",

note = "Funding Information: KORONA was established in July 2009 by the Clinical Research Center for Rheumatoid Arthritis and funded by the Ministry of Health and Affairs, South Korea. RA patients over the age of 18 who satisfied the 1987 American College of Rheumatology (ACR) classification criteria for RA [13] were recruited by rheumatologists from 23 centers across South Korea as part of KORONA. Among those patients, only postmenopausal women were enrolled in this study. A total of 3531 patients with RA were recruited between July 2009 and December 2011, and 1322 postmenopausal women whose BMD examination results were available within one year from the time of KORONA enrollment were included in this study (Fig. 1). The KORONA protocol was approved by the institutional review boards of Hanyang University Hospital and all participating hospitals, and informed consent was obtained from all patients before registration. Funding Information: This study was supported by a grant of the Korea Healthcare technology R&D Project, Ministry of Health and Welfare, Republic of Korea (A102065). Publisher Copyright: {\textcopyright} 2016 Lee et al.",

year = "2016",

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doi = "10.1186/s12891-016-0952-8",

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volume = "17",

journal = "BMC Musculoskeletal Disorders",

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TY - JOUR

T1 - The frequency of and risk factors for osteoporosis in Korean patients with rheumatoid arthritis

AU - Lee, Joo Hyun

AU - Sung, Yoon Kyoung

AU - Choi, Chan Bum

AU - Cho, Soo Kyung

AU - Bang, So Young

AU - Choe, Jung Yoon

AU - Hong, Seung Jae

AU - Jun, Jae Bum

AU - Kim, Tae Hwan

AU - Lee, Jisoo

AU - Lee, Hye Soon

AU - Yoo, Dae Hyun

AU - Yoon, Bo Young

AU - Bae, Sang Cheol

N1 - Funding Information: KORONA was established in July 2009 by the Clinical Research Center for Rheumatoid Arthritis and funded by the Ministry of Health and Affairs, South Korea. RA patients over the age of 18 who satisfied the 1987 American College of Rheumatology (ACR) classification criteria for RA [13] were recruited by rheumatologists from 23 centers across South Korea as part of KORONA. Among those patients, only postmenopausal women were enrolled in this study. A total of 3531 patients with RA were recruited between July 2009 and December 2011, and 1322 postmenopausal women whose BMD examination results were available within one year from the time of KORONA enrollment were included in this study (Fig. 1). The KORONA protocol was approved by the institutional review boards of Hanyang University Hospital and all participating hospitals, and informed consent was obtained from all patients before registration. Funding Information: This study was supported by a grant of the Korea Healthcare technology R&D Project, Ministry of Health and Welfare, Republic of Korea (A102065). Publisher Copyright: © 2016 Lee et al.

PY - 2016/2/24

Y1 - 2016/2/24

N2 - Background: The aim of this study was to investigate the prevalence of osteoporosis in rheumatoid arthritis (RA) patients and to analyze the risk factors in these patients using the KORean Observational study Network for Arthritis (KORONA) database. Methods: Among the RA patients in the KORONA who were recruited between July 2009 and December 2011, postmenopausal women with bone mineral density (BMD) results within one year from the time of KORONA enrollment were included in this study. The baseline characteristics of patients in three groups, defined by BMD results, were compared. The BMD measurement rates and prevalence of osteoporosis in the study patients were calculated in accordance with age and gender subgroups. Multivariable logistic regression analysis was used to explore the association between osteoporosis and demographics and disease-related risk factors. Results: Of 1322 postmenopausal woman patients with RA in whom BMD was measured within one year of study enrollment, 619 patients (46.8 %) were in the osteoporosis group (T-score ≤ -2.5 SD). RA patients with osteoporosis had a higher frequency of previous fractures than those in other groups, especially fractures of the femur (p = 0.004) and wrist (p = 0.042). Advanced age (≥70 years; OR = 2.28, 95 % CI: 1.40-3.58), lower body mass index (<25; OR = 2.14, 95 % CI:1.52-3.02), longer disease duration (≥10 years; OR = 1.46, 95 % CI: 1.07-2.00), higher cumulative glucocorticoid dose (OR = 1.03, 95 % CI: 1.01-1.05), and higher Health Assessment Questionnaire score (OR = 1.37, 95 % CI:1.11-1.69) were independent risk factors for osteoporosis. Conclusion: A large percentage (90.8 %) of RA patients enrolled in the KORONA cohort had osteoporosis and osteopenia. Nevertheless, BMD measurement rates in this population remained low, despite high risk groups of fractures.

AB - Background: The aim of this study was to investigate the prevalence of osteoporosis in rheumatoid arthritis (RA) patients and to analyze the risk factors in these patients using the KORean Observational study Network for Arthritis (KORONA) database. Methods: Among the RA patients in the KORONA who were recruited between July 2009 and December 2011, postmenopausal women with bone mineral density (BMD) results within one year from the time of KORONA enrollment were included in this study. The baseline characteristics of patients in three groups, defined by BMD results, were compared. The BMD measurement rates and prevalence of osteoporosis in the study patients were calculated in accordance with age and gender subgroups. Multivariable logistic regression analysis was used to explore the association between osteoporosis and demographics and disease-related risk factors. Results: Of 1322 postmenopausal woman patients with RA in whom BMD was measured within one year of study enrollment, 619 patients (46.8 %) were in the osteoporosis group (T-score ≤ -2.5 SD). RA patients with osteoporosis had a higher frequency of previous fractures than those in other groups, especially fractures of the femur (p = 0.004) and wrist (p = 0.042). Advanced age (≥70 years; OR = 2.28, 95 % CI: 1.40-3.58), lower body mass index (<25; OR = 2.14, 95 % CI:1.52-3.02), longer disease duration (≥10 years; OR = 1.46, 95 % CI: 1.07-2.00), higher cumulative glucocorticoid dose (OR = 1.03, 95 % CI: 1.01-1.05), and higher Health Assessment Questionnaire score (OR = 1.37, 95 % CI:1.11-1.69) were independent risk factors for osteoporosis. Conclusion: A large percentage (90.8 %) of RA patients enrolled in the KORONA cohort had osteoporosis and osteopenia. Nevertheless, BMD measurement rates in this population remained low, despite high risk groups of fractures.

KW - Frequency

KW - Osteoporosis

KW - Rheumatoid arthritis

KW - Risk factors

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DO - 10.1186/s12891-016-0952-8

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C2 - 26912147

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SN - 1471-2474

VL - 17

JO - BMC Musculoskeletal Disorders

JF - BMC Musculoskeletal Disorders

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ER -

The frequency of and risk factors for osteoporosis in Korean patients with rheumatoid arthritis

Abstract

Bibliographical note

Keywords

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