Prevalence and risk factors of vertebral fractures in women with rheumatoid arthritis using vertebral fracture assessment.
OBJECTIVE
To study the prevalence and risk factors of vertebral fractures (VFs) in a large cohort of patients with RA using VF assessment (VFA).


METHODS
We enrolled 172 women with RA, none of whom were taking osteoporosis medications. Patients underwent dual X-ray absorptiometry at the hip and spine and VFA, and completed a questionnaire. Radiological status was assessed by the modified Sharp erosion and narrowing score. VFA was classified using a combination of Genant semi-quantitative approach and morphometry.


RESULTS
Patients had a mean (s.d.) disease duration of 8.4 (5.2) years. VFs were detected in 36% (62/172). This group of women had a statistically significant lower weight, height and lumbar spine and total hip BMD and T-scores than those without a VFA-identified VF. They also had more long-standing and severe disease and a greater consumption of corticosteroids. Stepwise regression analysis showed that the presence of VFs was independently associated with low weight and total hip T-score and long disease duration, CRP and Sharp erosion score.


CONCLUSIONS
RA is a risk factor on its own for the development of osteoporosis and VFs and this risk increases more with low weight, disease duration and severe course of disease. These findings may suggest that to prevent the development of VFs, precautions should be taken immediately to suppress the disease activity and correct the weight loss in patients with RA.
El Maghraoui
Abdellah
A
Rheumatology Department, Military Hospital Mohammed V, PO Box 1018, Rabat, Morocco. aelmaghraoui@gmail.com
Rezqi
Asmaa
A
Mounach
Aziza
A
Achemlal
Lahsen
L
Bezza
Ahmed
A
Ghozlani
Imad
I
D015502:Absorptiometry, Photon / Q000379:methods; D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000150:complications*; D015519:Bone Density; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications*; D011237:Predictive Value of Tests; D015995:Prevalence; D012044:Regression Analysis; D012307:Risk Factors; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000209:etiology*; D011795:Surveys and Questionnaires; D013997:Time Factors