Year: 2025
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Patients with rheumatoid arthritis (RA) are at an increased risk of developing osteoporosis and fractures, particularly when treated with glucocorticoids. Trabecular bone score (TBS) is a valuable complementary tool for evaluating bone microarchitecture, enhancing the prediction of fracture risk beyond bone mineral density (BMD). OBJECTIVE: To determine factors associated with osteoporosis and degraded TBS in RA patients. METHODS: A cross-sectional study was conducted on 131 RA patients treated at Nguyen Tri Phuong Hospital. BMD and TBS were evaluated according to Asian reference standards; osteoporosis was defined according to WHO criteria and TBS was categorized using two cut-off points of < 1.23 (degraded) and 1.32 (normal). General risk factors and RA-specific factors were analyzed using univariate analysis, followed by multivariate logistic regression to identify factors associated with osteoporosis (T-score ≤ -2.5) and degraded TBS (< 1.23). RESULTS: Osteoporosis was identified in 22.1% of patients, while more patients (26%) exhibited degraded TBS. Combining BMD with TBS identified 32.8% of patients as high risk. Factors associated with osteoporosis included advanced age (OR = 1.05, p = 0.05), lower body weight (OR = 0.94, p = 0.02), and sarcopenia (OR = 2.99, p = 0.08). Degraded TBS was significantly associated with older age (OR = 1.13, p < 0.005) and structural RA-associated bone damage (OR = 2.50, p = 0.09). CONCLUSION: The study highlights that advanced age, low body weight, and sarcopenia are key factors associated with osteoporosis in RA patients. Similarly, older age and RA-associated structural damage, are associated with degraded TBS. The combination of BMD and TBS is recommended for bone health assessment in rheumatoid arthritis patients.
Authors: Huong Nguyen, Cong Minh Doan, Karen Hind, Cao Phuong Duy Le, Khoa Nguyen
Language: English
Subfield: Orthopedics and Sports Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4417104264