Bone mineral density of the lumbar spine in patients with advanced rheumatoid arthritis - Influence of functional capacity and corticosteroid use

We investigated factors that are related to generalized osteoporosis in adv anced rheumatoid arthritis (RA). In this cross-sectional study we measured trabecular bone mineral density (BMD), by quantitative computerized tomogra phy (QCT), in the lumbar spine of 57 patients with RA, most of whom were pr emenopausal women. In our material, 27 out of 57 patients (47 %) had BMD < -1 SD expressed as Z-score and five patients had suffered from fractures. O ur study shows that a cumulative corticosteroid dose (r=-0.41, p<0.010) and functional impairment (r=-0.37, p<0.050) were negatively related to spinal BMD, while daily intake of calcium correlated positively on BMD (r=0.37, p <0.010). Our results indicate that low BMD is common in patients with advan ced RA and it is associated with long-term corticosteroid use. Thus, in cli nical practice we have to consider the benefits and harms of corticosteroid treatment and preventive therapy to osteoporosis.