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Background: Though inflammatory arthritis’ are known to affect bone density, the comparative effect of each arthritis is not known.
Objectives: To compare the bone mineral densities (BMD) and T scores, and eventually judge the bone health, in common inflammatory arthritis’ (IA) such as rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), ankylosing spondylitis (AS), seronegative spondyloarthropathy (SSA) and psoriatic arthritis (PsA).
Methods: We retrospectively examined BMDs of consecutive consenting patients with the diagnosis of RA, SLE, AS, SSA, and PsA at their first visit to the center at the time of diagnosis. This was done on GE lunar Dual energy x-ray absorptiometry (DEXA) machine and T scores were obtained. Mean ± SD values of T scores at spine, femur neck and femur total were calculated for each condition.
Results: The number of patients included in the study is mentioned in the Table 1. The numbers reflect the distribution of these arthritis’ in the population. T scores ± SD are tabulated. The BMD values are lowest for patients with RA, while they were highest for SLE patients. Other inflammatory arthritis had intermediate values. The higher BMD in SLE females could be attributed to their early presentation in their course of the disease. T scores of male SLE patients (n=3) cannot be considered for evaluation due to their low numbers. Female patients with RA had significantly lower BMDs as compared to AS, SSA and SLE, while the difference reached near significance as compared to PsA (p=0.07). In male RA patients, BMDs were not significantly different as compared to other IAs, except PsA.
| FEMALES | |||||
|---|---|---|---|---|---|
| RA | PsA | AS | SSA | SLE | |
| n = 2288 | n = 115 | n = 90 | n = 157 | n = 48 | |
| Age | 49.3 ± 12.4 | 47.1 ± 11.9 | 35.4 ± 12.8 | 42.1 ± 12.0 | 35 ± 9.3 |
| Mean T scores Femur neck | -1.54 ± 1.07 | -1.1 ± 1.04 | -1.08 ± 0.9* | -0.96 ± 1.01** | -0.89 ± 0.86** |
| Mean T scores Femur total | -1.3 ± 1.18 | -0.75 ± 1.23 | -0.76 ± 1.13* | -0.74 ± 1.13** | -0.63 ± 0.99** |
| Mean T scores Spine | -1.76 ± 1.34 | -1.4 ± 1.51 | -1.3 ± 1.39* | -1.07 ± 1.5** | -0.93 ± 1.23** |
| MALES | |||||
| n = 422 | n = 119 | n = 294 | n = 196 | n = 3 | |
| Age | 51.3 ± 13.3 | 48.6 ± 12.3 | 32.9 ± 11.3 | 40.7 ± 14.1 | 35.5 ± 20.4 |
| Mean T scores Femur neck | -1.44 ± 1.09 | -0.97 ± 1.07* | -1.33 ± 1.16 | -1.07 ± 1.06 | -1.63 ± 0.78 |
| Mean T scores Femur total | -1.26 ± 1.04 | -0.87 ± 0.92* | -1.31 ± 1.06 | -1.06 ± 1.02 | -1.5 ± 0.72 |
| Mean T scores Spine | -1.64 ± 1.2 | -1.23 ± 1.28* | -1.81 ± 1.36 | -1.36 ± 1.25 | -2.47 ± 1.17 |
*p<0.05, **p<0.001
Conclusion: Female RA patients had worst BMD values as compared to other IA. The difference in bone densities of different arthritis’ could be due to the different cytokine profiles of each arthritis. Various cytokines may have a different effect on bone metabolism and could play a role in the extent of bone porosis. Gender could play a role in the variable effects in males and females. Large patient population is the strength of this study.
REFERENCES: NIL.
Acknowledgements: NIL.
Disclosure of Interests: None declared.
© The Authors 2025. This abstract is an open access article published in Annals of Rheumatic Diseases under the CC BY-NC-ND license (