Risk factors for osteoporosis in patients with rheumatoid arthritis

Aim of the study was to investigate risk factors for osteoporosis (OP) in patients with rheumatoid arthritis (RA). Material and methods. We observed 110 patients with a verified diagnosis of RA. RA was diagnosed based on the 2010 EULAR/ACR clinical classification. All patients with RA were divided into 2 groups: with ОP (53 patients) and without ОP signs (57 patients). Bone mineral density (BMD) was assessed by dual-energy X-ray densitometry (DEXA), the diagnosis was made on the basis of WHO recommendations. All patients underwent a standard clinical and laboratory examination, in addition the following parameters were studied: 25-OH vitamin D, C-terminal telopeptide of type I collagen (CTX-1), N-terminal propeptide of procollagen I (P1NP) content in the blood, the ratio of calcium to urine creatinine. Results. We found a statistically significant relationship between the presence of ОP and the following clinical signs: patient weight (р = 0.014), duration of RA course (р = 0.024), and the presence of erosive changes (р = 0.014). In addition, a relationship was found between the presence of OP and lower BMD in the Ward area (Ward) and the greater trochanter area (Troch) (р < 0.0001). It was also shown that taking glucocorticosteroid drugs for more than 3 months significantly increases the risk of developing ОP (р < 0.0001). Conclusions. Identification of risk groups for patients at risk for the development of OP is of great practical importance. The factors given in the article can be adjusted towards normalization in order to reduce the degree of possible risk, which is quite feasible in practice.