Male patients with rheumatoid arthritis have an increased risk of osteoporosis: Frequency and risk factors

Seong Min Kweon; Dong Hyun Sohn; Ji Heh Park; Jung Hee Koh; Eun Kyoung Park; Han Na Lee; Keunyoung Kim; Yunkyung Kim; Geun Tae Kim; Seung Geun Lee

doi:10.1097/MD.0000000000011122

Male patients with rheumatoid arthritis have an increased risk of osteoporosis: Frequency and risk factors

Seong Min Kweon, Dong Hyun Sohn, Ji Heh Park, Jung Hee Koh, Eun Kyoung Park, Han Na Lee, Keunyoung Kim, Yunkyung Kim, Geun Tae Kim, Seung Geun Lee

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

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Abstract

Most previous research investigating osteoporosis in rheumatoid arthritis (RA) has focused on female patients and there is a lack of data regarding clinical characteristics of osteoporosis in male patients with RA. The aim of this study was to compare the frequency of osteoporosis between male patients with RA and healthy patients, and to identify the risk factors for osteoporosis and low bone mineral density (BMD) in male patients with RA. We conducted a retrospective, cross-sectional study including 76 South Korean male patients with RA aged over 50 years and 76 age-matched male healthy individuals. BMD was measured at the lumbar spine (L1-4) and left hip (femoral neck and total hip) using dual energy X-ray absorptiometry. Osteoporosis was defined as a T-score of -2.5 according to the World Health Organization (WHO) classification. The frequency of osteoporosis at either the spine or the hip among male patients with RA was significantly higher than that among controls (22.4% vs 10.5%, P = .049) and RA patients had a significantly lower total hip BMD than healthy individuals (0.92 ± 0.14 vs 0.96 ± 0.1 g/cm², P = .027). For male RA patients, the mean 28-joint Disease Activity Scores using erythrocyte sedimentation rate (DAS28-ESR) and body mass index (BMI) were 3.28 and 22 kg/m², respectively. In multivariable logistic regression models, BMI 22 kg/m² (odds ratio = 3.43, P = .043) and DAS28-ESR > 3.2 (odds ratio = 3.85, P = .032) were independent risk factors for osteoporosis at either site in male patients with RA. Our data demonstrate that male patients with RA had a 2.1 times higher risk for osteoporosis compared with healthy individuals. This suggests that appropriate management of osteoporosis in patients with RA is crucial not only for postmenopausal women but also for men aged over 50 years, especially those with low BMI and higher disease activity.

Original language	English
Article number	e11122
Journal	Medicine (United States)
Volume	97
Issue number	24
DOIs	https://doi.org/10.1097/MD.0000000000011122
State	Published - Jun 2018

Bibliographical note

Funding Information:
S-MK and DHS contributed equally to this work. Funding/support: This work was supported by Pusan National University Research Grant, 2015. The authors report no conflicts of interest. aDivision of Rheumatology, Department of Internal Medicine, Pusan National University School of Medicine, Pusan National University Hospital, Busan, bDepartment of Microbiology and Immunology, Pusan National University School of Medicine, Yangsan, cDepartment of Nuclear Medicine, dBiomedical Research Institute, Pusan National University Hospital, eDivision of Rheumatology, Department of Internal Medicine, Kosin University College of Medicine, Busan, South Korea. ∗Correspondence: Seung-Geun Lee, Division of Rheumatology, Department of Internal Medicine, Pusan National University School of Medicine, Pusan National University Hospital, 179 Gudeok-Ro, Seo-Gu, 49241 Busan, South Korea (e-mail: [email protected]). Copyright © 2018 the Author(s). Published by Wolters Kluwer Health, Inc. This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

Publisher Copyright:
Copyright © 2018 the Author(s). Published by Wolters Kluwer Health, Inc.

Keywords

Bone density
Inflammation
Male
Osteoporosis
Rheumatoid arthritis

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10.1097/MD.0000000000011122

Cite this

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title = "Male patients with rheumatoid arthritis have an increased risk of osteoporosis: Frequency and risk factors",

abstract = "Most previous research investigating osteoporosis in rheumatoid arthritis (RA) has focused on female patients and there is a lack of data regarding clinical characteristics of osteoporosis in male patients with RA. The aim of this study was to compare the frequency of osteoporosis between male patients with RA and healthy patients, and to identify the risk factors for osteoporosis and low bone mineral density (BMD) in male patients with RA. We conducted a retrospective, cross-sectional study including 76 South Korean male patients with RA aged over 50 years and 76 age-matched male healthy individuals. BMD was measured at the lumbar spine (L1-4) and left hip (femoral neck and total hip) using dual energy X-ray absorptiometry. Osteoporosis was defined as a T-score of -2.5 according to the World Health Organization (WHO) classification. The frequency of osteoporosis at either the spine or the hip among male patients with RA was significantly higher than that among controls (22.4% vs 10.5%, P = .049) and RA patients had a significantly lower total hip BMD than healthy individuals (0.92 ± 0.14 vs 0.96 ± 0.1 g/cm2, P = .027). For male RA patients, the mean 28-joint Disease Activity Scores using erythrocyte sedimentation rate (DAS28-ESR) and body mass index (BMI) were 3.28 and 22 kg/m2, respectively. In multivariable logistic regression models, BMI 22 kg/m2 (odds ratio = 3.43, P = .043) and DAS28-ESR > 3.2 (odds ratio = 3.85, P = .032) were independent risk factors for osteoporosis at either site in male patients with RA. Our data demonstrate that male patients with RA had a 2.1 times higher risk for osteoporosis compared with healthy individuals. This suggests that appropriate management of osteoporosis in patients with RA is crucial not only for postmenopausal women but also for men aged over 50 years, especially those with low BMI and higher disease activity.",

keywords = "Bone density, Inflammation, Male, Osteoporosis, Rheumatoid arthritis",

author = "Kweon, {Seong Min} and Sohn, {Dong Hyun} and Park, {Ji Heh} and Koh, {Jung Hee} and Park, {Eun Kyoung} and Lee, {Han Na} and Keunyoung Kim and Yunkyung Kim and Kim, {Geun Tae} and Lee, {Seung Geun}",

note = "Funding Information: S-MK and DHS contributed equally to this work. Funding/support: This work was supported by Pusan National University Research Grant, 2015. The authors report no conflicts of interest. aDivision of Rheumatology, Department of Internal Medicine, Pusan National University School of Medicine, Pusan National University Hospital, Busan, bDepartment of Microbiology and Immunology, Pusan National University School of Medicine, Yangsan, cDepartment of Nuclear Medicine, dBiomedical Research Institute, Pusan National University Hospital, eDivision of Rheumatology, Department of Internal Medicine, Kosin University College of Medicine, Busan, South Korea. ∗Correspondence: Seung-Geun Lee, Division of Rheumatology, Department of Internal Medicine, Pusan National University School of Medicine, Pusan National University Hospital, 179 Gudeok-Ro, Seo-Gu, 49241 Busan, South Korea (e-mail: [email protected]). Copyright {\textcopyright} 2018 the Author(s). Published by Wolters Kluwer Health, Inc. This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. Publisher Copyright: Copyright {\textcopyright} 2018 the Author(s). Published by Wolters Kluwer Health, Inc.",

year = "2018",

month = jun,

doi = "10.1097/MD.0000000000011122",

language = "English",

volume = "97",

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T1 - Male patients with rheumatoid arthritis have an increased risk of osteoporosis

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AU - Kweon, Seong Min

AU - Sohn, Dong Hyun

AU - Park, Ji Heh

AU - Koh, Jung Hee

AU - Park, Eun Kyoung

AU - Lee, Han Na

AU - Kim, Keunyoung

AU - Kim, Yunkyung

AU - Kim, Geun Tae

AU - Lee, Seung Geun

N1 - Funding Information: S-MK and DHS contributed equally to this work. Funding/support: This work was supported by Pusan National University Research Grant, 2015. The authors report no conflicts of interest. aDivision of Rheumatology, Department of Internal Medicine, Pusan National University School of Medicine, Pusan National University Hospital, Busan, bDepartment of Microbiology and Immunology, Pusan National University School of Medicine, Yangsan, cDepartment of Nuclear Medicine, dBiomedical Research Institute, Pusan National University Hospital, eDivision of Rheumatology, Department of Internal Medicine, Kosin University College of Medicine, Busan, South Korea. ∗Correspondence: Seung-Geun Lee, Division of Rheumatology, Department of Internal Medicine, Pusan National University School of Medicine, Pusan National University Hospital, 179 Gudeok-Ro, Seo-Gu, 49241 Busan, South Korea (e-mail: [email protected]). Copyright © 2018 the Author(s). Published by Wolters Kluwer Health, Inc. This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. Publisher Copyright: Copyright © 2018 the Author(s). Published by Wolters Kluwer Health, Inc.

PY - 2018/6

Y1 - 2018/6

N2 - Most previous research investigating osteoporosis in rheumatoid arthritis (RA) has focused on female patients and there is a lack of data regarding clinical characteristics of osteoporosis in male patients with RA. The aim of this study was to compare the frequency of osteoporosis between male patients with RA and healthy patients, and to identify the risk factors for osteoporosis and low bone mineral density (BMD) in male patients with RA. We conducted a retrospective, cross-sectional study including 76 South Korean male patients with RA aged over 50 years and 76 age-matched male healthy individuals. BMD was measured at the lumbar spine (L1-4) and left hip (femoral neck and total hip) using dual energy X-ray absorptiometry. Osteoporosis was defined as a T-score of -2.5 according to the World Health Organization (WHO) classification. The frequency of osteoporosis at either the spine or the hip among male patients with RA was significantly higher than that among controls (22.4% vs 10.5%, P = .049) and RA patients had a significantly lower total hip BMD than healthy individuals (0.92 ± 0.14 vs 0.96 ± 0.1 g/cm2, P = .027). For male RA patients, the mean 28-joint Disease Activity Scores using erythrocyte sedimentation rate (DAS28-ESR) and body mass index (BMI) were 3.28 and 22 kg/m2, respectively. In multivariable logistic regression models, BMI 22 kg/m2 (odds ratio = 3.43, P = .043) and DAS28-ESR > 3.2 (odds ratio = 3.85, P = .032) were independent risk factors for osteoporosis at either site in male patients with RA. Our data demonstrate that male patients with RA had a 2.1 times higher risk for osteoporosis compared with healthy individuals. This suggests that appropriate management of osteoporosis in patients with RA is crucial not only for postmenopausal women but also for men aged over 50 years, especially those with low BMI and higher disease activity.

AB - Most previous research investigating osteoporosis in rheumatoid arthritis (RA) has focused on female patients and there is a lack of data regarding clinical characteristics of osteoporosis in male patients with RA. The aim of this study was to compare the frequency of osteoporosis between male patients with RA and healthy patients, and to identify the risk factors for osteoporosis and low bone mineral density (BMD) in male patients with RA. We conducted a retrospective, cross-sectional study including 76 South Korean male patients with RA aged over 50 years and 76 age-matched male healthy individuals. BMD was measured at the lumbar spine (L1-4) and left hip (femoral neck and total hip) using dual energy X-ray absorptiometry. Osteoporosis was defined as a T-score of -2.5 according to the World Health Organization (WHO) classification. The frequency of osteoporosis at either the spine or the hip among male patients with RA was significantly higher than that among controls (22.4% vs 10.5%, P = .049) and RA patients had a significantly lower total hip BMD than healthy individuals (0.92 ± 0.14 vs 0.96 ± 0.1 g/cm2, P = .027). For male RA patients, the mean 28-joint Disease Activity Scores using erythrocyte sedimentation rate (DAS28-ESR) and body mass index (BMI) were 3.28 and 22 kg/m2, respectively. In multivariable logistic regression models, BMI 22 kg/m2 (odds ratio = 3.43, P = .043) and DAS28-ESR > 3.2 (odds ratio = 3.85, P = .032) were independent risk factors for osteoporosis at either site in male patients with RA. Our data demonstrate that male patients with RA had a 2.1 times higher risk for osteoporosis compared with healthy individuals. This suggests that appropriate management of osteoporosis in patients with RA is crucial not only for postmenopausal women but also for men aged over 50 years, especially those with low BMI and higher disease activity.

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KW - Rheumatoid arthritis

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ER -

Male patients with rheumatoid arthritis have an increased risk of osteoporosis: Frequency and risk factors

Abstract

Bibliographical note

Keywords

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