Low serum albumin concentration is associated with increased risk of osteoporosis in postmenopausal patients with rheumatoid arthritis
| Autor: | Jun Hashimoto, Hideki Tsuboi, Yoshio Nagayama, Kosuke Ebina, Hideki Yoshikawa, Ken Nakata, Seiji Okada, Makoto Hirao |
|---|---|
| Rok vydání: | 2022 |
| Předmět: |
medicine.medical_specialty
Osteoporosis Serum albumin Gastroenterology Bone remodeling Arthritis Rheumatoid Absorptiometry Photon Bone Density Internal medicine medicine Humans Orthopedics and Sports Medicine Serum Albumin Osteoporosis Postmenopausal Aged Retrospective Studies Femoral neck Bone mineral Lumbar Vertebrae biology business.industry medicine.disease Postmenopause medicine.anatomical_structure Rheumatoid arthritis Propensity score matching Prednisolone biology.protein Female Surgery business medicine.drug |
| Zdroj: | Journal of Orthopaedic Science. 27:1283-1290 |
| ISSN: | 0949-2658 |
| Popis: | The risk of osteoporosis in patients with rheumatoid arthritis (RA) is frequently overlooked, and investigating a simple indicator in routine care may be beneficial to motivate osteoporosis examination. The aim of this retrospective, case-controlled study was to identify the correlation between serum albumin concentrations and the prevalence of osteoporosis in postmenopausal patients with RA.This study enrolled 197 patients who underwent dual-energy X-ray absorptiometry of lumbar spine (LS) and proximal femur without osteoporosis treatment [mean age, 67.5 years; disease duration, 12.8 years; Disease Activity Score assessing 28 joints with C-reactive protein, 2.0; prednisolone dose, 4.9 mg/day (usage, 42.6%); and LS T-score, -1.9]. Patients were classified into 2 groups: osteoporosis, defined as ≥ 1 part bone mineral density T-score ≤ -2.5 or history of fragility fracture of the vertebra or proximal femur (121 patients), and non-osteoporosis (76 patients). Groups were then matched by propensity score using clinical backgrounds affecting bone metabolism.In non-matched model, serum albumin concentration was significantly associated with osteoporosis-related factors such as aging, inflammation, physical disability, and glucocorticoid dose. Multivariate logistic regression revealed that serum albumin concentration was independently and significantly associated with osteoporosis risk (odds ratio = 0.22, 95% confidence interval = 0.08, 0.61, p = 0.0033). After propensity score matching, 57 patients for each group showed that in addition to the LS and femoral neck T-scores (p 0.001), serum albumin concentrations (p = 0.01) remained lower in the osteoporosis group compared to non-osteoporosis group. Receiver operating characteristic curve analysis in non-matched model revealed that when cut-off value of serum albumin concentration for indicating osteoporosis was set at 4.2 g/dl, the area under the curve was 0.69, sensitivity 0.74, and specificity 0.58.Low serum albumin concentration was significantly and independently associated with the prevalence of osteoporosis, which may be considered as one of the osteoporosis-related factors in postmenopausal patients with RA. |
| Databáze: | OpenAIRE |
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