Bone Mineral Density in Patients With Early- Onset Rheumatoid Arthritis

Objective: Rheumatoid arthritis (RA) is a chronic inflammatory and destructive joint disease that affects 0.5-1% of the world's population and commonly leads to significant disability and consequent impairment of quality of life. Osteoporosis is an early and common feature in RA and occurs during the course of the disease as extra-articular manifestation of rheumatoid arthritis, which may result in increased risk of fractures, morbidity, and mortality. The aim of this study was to evaluate changes in bone mineral density in patients with early- onset rheumatoid arthritis including its correlation with disease activity. Method: Ther study was performed with 50 patients diagnosied as early- onset rheumatoid made less than two years ago n the Private Clinic "Rheuma", who fulfilled the diagnostic criteria of American College of Rheumatology/ European League Against Rheumatism and 30 healthy volunteers as controls. Bone mineral density of these patients was measured at lumbar spine and hip by using dual energy x-ray absorptiometry scan (DEXA Stratos 800). Demographic and clinical data including age, gender, BMI, menstrual status, disease duration, laboratory tests, and disease activity scale (DAS28) scores were collected. Results: From a total of 50 patients with RA, 36 were females and 14 were males with an overall mean age of 27-57 (33.7 +/- 7.87 years), fulfilling ACR/EULAR Criteria. The patients with RA, had osteoporosis (16%), osteopenia (65%) and normal BMD (30%) values. In the group of RA patients with osteoporosis had higher disease activity scores (DAS-28) without any statistically significant correlation compared to RA patients with normal BMD values or osteopenia. Conclusion: Patients with RA are more likely to have bone loss compared to normal age subjects. Lower BMD values were found in patients at earlier stage of the rheumatoid arthritis with higher disease activity. Dual energy x-ray absorptiometry is an important tool to assess BMD in early RA patients.