Lean mass and disease activity are the best predictors of bone mineral loss in the premenopausal women with rheumatoid arthritis

• Published in: Indian journal of endocrinology and metabolism 2018-03, Vol.22 (2), p.236-243
• Main Authors: Sharma, Meha, Dhakad, Urmila, Wakhlu, Anupam, Bhadu, Danveer, Dutta, Deep, Das, Siddharth
• Format: Article
• Language: English
• Subjects: Bone mineral density; Care and treatment; Complications and side effects; disease activity score; Health aspects; lean mass; Original; Osteoporosis; Postmenopausal women; Rheumatoid arthritis; Risk factors
• ISSN: 2230-8210; 2230-9500
• DOI: 10.4103/ijem.IJEM_665_17

Background and Objectives: Factors determining bone mineral (BM) loss in rheumatoid arthritis (RA) are not well known. This study aimed to determine the occurrence and predictors of BM loss in the young premenopausal women with RA. Methods: Ninety-six females with RA and 90 matched controls underwent clinical, biochemical, BM density (BMD), and body composition assessments. RA disease activity was assessed using disease activity score-28 (DAS-28) and hand X-ray. Results: In the young premenopausal females with RA having median symptom and treatment duration of 30 (18-60) and 4 (2-12) months, respectively, with moderate disease activity (DAS-28, 4.88 ± 1.17), occurrence of osteoporosis and osteopenia was 7.29% and 25% at spine, 6.25% and 32.29% at hip, and 17.7% and 56.25% at wrist, respectively (significantly higher than controls). RA patients had lower BMD at total femur, lumbar spine (LS), radius total, and radius ultra-distal. Total lean mass (LM) and BM content were significantly lower in RA (P = 0.022 and