Prevalence and Risk Factors of Osteoporosis among Rheumatoid Arthritis Patients in Taiwan: A Single-Center Retrospective Study in Southern Taiwan

台灣類風濕性關節炎患者骨質疏鬆症盛行率和風險因子：單一中心回溯性研究

黃凱婧(Khai-Jing Ng) ； 呂明錡(Ming-Chi Lu) ； 黃光永(Kuang-Yung Huang) ； 童建學(Chien-Hsueh Tung) ； 許寶寶(Bao-Bao Hsu) ； 吳政翰(Cheng-Han Wu) ； 辜美安(Malcolm Koo) ； 許嘉紋(Chia-Wen Hsu) ； 賴寧生(Ning-Sheng Lai)

《Formosan Journal of Rheumatology》 32卷1期 (2018/09) Pp. 10-17

https://doi.org/10.6313/FJR.201809_32(1).0002

摘要

Objectives: To evaluate the prevalence of osteoporosis among rheumatoid arthritis (RA) patients, compared to the general population, and to identify the risk factors for osteoporosis in RA patients. Methods: In this retrospective study, RA patients were recruited from the rheumatology division of a regional hospital in southern Taiwan. Non-RA controls were sampled from the health examination database of the study hospital, based on frequency matching by age and sex. Information on demographic and lifestyle-related characteristics was obtained. Levels of rheumatoid factor (RF), anti-cyclic citrullinated peptide antibody (anti-CCP Ab), and bone mineral density (BMD) levels for the lumbar spine and bilateral femoral neck were obtained. Factors associated with osteoporosis were assessed using logistic regression analysis. Results: A total of 361 RA patients (78.1% female) and 360 non-RA patients (77.8% female) were included in this study. The prevalence of osteoporosis was 32.7% and 20.0% in RA and non-RA groups, respectively (p = 0.001). Older age, female gender, previous fracture, and lower body mass index were significantly associated with an increased risk of osteoporosis in patients with RA. RF and anti-CCP Ab and were not significantly associated with osteoporosis in RA patients. Conclusion: Prevalence of osteoporosis was significantly higher in RA patients compared to non-RA controls. Older age, lower body mass index, female gender, and previous fracture were significantly associated with an increased risk of osteoporosis in RA patients.

關鍵字

osteoporosis ； rheumatoid arthritis

並列摘要

目的：探討類風濕性關節炎病患骨質疏鬆症的盛行率並找出其相關風險因子。方法：本回溯性研究於南部某區域醫院風濕科類風濕性關節炎病患進行收案，並於健康檢查資料庫以性別及年齡配對抽樣非類風濕性關節炎的健康對照組。收集人口學及生活型態特性資料以及風濕因子、CCP抗體與腰椎和股骨頸骨密度水平，以羅吉斯迴歸分析骨質疏鬆症的雙關因子。結果：本研究共納入361位類風濕性關節炎病患（78.1% 女性）和360位非類風濕性關節炎的健康對照組（77.8% 女性）。骨質疏鬆症的盛行率分別為類風濕性關節炎組32.7%和對照組20.0% (p =0.001)。較大年齡、女性、過去骨折和低身體質量指數皆為骨質疏鬆症的危險因子。CCP抗體和風濕因子兩者則與骨質疏鬆症無顯著關聯。結論：骨質疏鬆症的盛行率在類風濕性關節炎患者顯著高於對照組。較大年齡、女性、低身體質量指數和過去骨折皆是類風濕性關節炎病患罹患骨質疏鬆症的風險因子。類固醇在類風濕性關節炎患者扮演的角色仍有待進一步研究證實。

並列關鍵字

骨質疏鬆症 ； 類風濕性關節炎