title: High frequency of vertebral fracture and low bone quality in patients with rheumatoid arthritis-Results from TOMORROW study.
abstract: OBJECTIVE
  Osteoporosis is one of the complications in patients with rheumatoid arthritis (RA). In this study, we researched the morbidity of existing vertebral fractures and the risk factors for vertebral fractures in patients with RA.
  
  
  METHODS
  This study included 413 participants, 208 patients with RA, and 205 age- and sex-matched controls without RA. Clinical data, radiographic assessment of vertebral fracture from T4 to L4 in thoracic and lumber spine, bone mineral density (BMD), and bone metabolic markers (BMM) were analyzed.
  
  
  RESULTS
  Vertebral fractures were observed more frequently, severe and multiple in patients with RA. In the logistic regression analysis, age (adjusted odds ratios (OR): 1.07, 95% confidence interval (CI): 1.04-1.09) and RA (adjusted OR: 1.72, 95% CI: 1.04-2.83) were risk factors for existing vertebral fracture. Moreover, two bone matrix-related markers, undercarboxylated osteocalcin (ucOC) (adjusted OR: 1.68, 95% CI: 1.02-2.78), and urinary pentocidine (adjusted OR: 2.51, 95% CI: 1.48-4.24) were associated with existing vertebral fracture.
  
  
  CONCLUSIONS
  High frequent, multiple, and severe vertebral fractures were found in patients with RA compared to the controls. Low bone quality might be the cause of the frequent prevalence of vertebral fracture in patients with RA.
authors.affiliation: a Department of Orthopaedic Surgery , Osaka City University Medical School , Osaka , Japan.
authors.forename: Tadashi
authors.initials: T
authors.lastname: Okano
authors.affiliation: a Department of Orthopaedic Surgery , Osaka City University Medical School , Osaka , Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Inui
authors.affiliation: b Department of Orthopaedic Surgery , Osaka City General Hospital , Osaka , Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Tada
authors.affiliation: c Center for Senile Degenerative Disorders (CSDD), Osaka City University Medical School , Osaka , Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Sugioka
authors.affiliation: a Department of Orthopaedic Surgery , Osaka City University Medical School , Osaka , Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Mamoto
authors.affiliation: d Department of Health and Sports Sciences , Mukogawa Women's University , Hyogo , Japan , and.
authors.forename: Shigeyuki
authors.initials: S
authors.lastname: Wakitani
authors.affiliation: c Center for Senile Degenerative Disorders (CSDD), Osaka City University Medical School , Osaka , Japan.|e Shirahama Foundation for Health and Welfare , Search Institute for Bone and Arthritis Disease (SINBAD) , Wakayama , Japan.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Koike
authors.affiliation: a Department of Orthopaedic Surgery , Osaka City University Medical School , Osaka , Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Nakamura
mesh_terms: D000368:Aged; D001172:Arthritis, Rheumatoid / Q000150:complications* / Q000453:epidemiology; D015519:Bone Density; D005260:Female; D006801:Humans; D008875:Middle Aged; D010024:Osteoporosis / Q000453:epidemiology / Q000209:etiology*; D016103:Spinal Fractures / Q000453:epidemiology*
keywords: Bone mineral density; Bone quality; Osteoporosis; Rheumatoid arthritis; Vertebral fracture