Osteoporosis in rheumatic diseases

Abstract

Background: Inflammatory joint disease such as rheumatoid arthritis, as well as other rheumatic conditions, such as Systemic Lupus Erythematosus (SLE) and ankylosing spondylitis comprise a heterogeneous group of joint disorders that are all associated with extra-articular manifestations, including bone loss and fractures.

Objectives: Evaluation of osteoporosis burden on patients with rheumatic diseases by determining the frequency of osteoporosis among those patients and to study the risk factors of osteoporosis in patients with rheumatic diseases.

Methods: The inclusion criteria for the study were all patients who were diagnosed to have rheumatic diseases that attended to Rheumatology Clinic of Tripoli Medical center, Tripoli, Libya, for follow up in the period from May 2013 to December 2013. Dual Energy X-ray Absorptiometry (DEXA) scan for the lumber spine and the hips was done for all patients. Demographic details such as age, sex and menopausal status were recorded. Clinical characteristics such as drugs used for every patient, steroid maintenance dose and duration of taking steroid were noted. Other clinical data as history of previous fractures and family history of osteoporosis were also determined.

Results: The study included 100 patients who had rheumatic diseases and followed in rheumatology out patients’ clinic. Osteoporosis was detected in 37/100 (37%) of patients. Osteopenia occurred in 51/100 (51%) of patients. Normal DEXA scan presented in 12/100 (12%) of the patients. Thirty seven patients who had osteoporosis, 5/37 (13.5%) were male and 32/37 (86.4%) were female. Thirty two female patients, 4/32 (12.5%) were in premenopausal age and 28/32 (87.5%) were in postmenopausal age. Most patients who had osteoporosis, 32/37 (86%) were taking steroid in form of prednisolone tablets. Previous fractures occurred in 4/37 (10.8%) of osteoporotic patients. Family history of osteoporosis was found in 4/37 (10.8%).

Conclusion: Presence of osteoporosis in 37% and osteopenia in 51% of our patients indicate a large burden of osteoporosis on patients with rheumatic diseases. Multiple risk factors of osteoporosis present in our patients, family history of osteoporosis in the first degree relatives in 10.8%, previous history of factures in 10.8% and long term use of corticosteroid treatment in 86%.

Keywords: Osteoporosis, Rheumatic diseases