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

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36 Scopus citations


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 languageEnglish
Article number98
JournalBMC Musculoskeletal Disorders
Issue number1
StatePublished - 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.


  • Frequency
  • Osteoporosis
  • Rheumatoid arthritis
  • Risk factors


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