To investigate the systemic and local factors effecting on the bone mineral density of patients with rheumatoid arthritis (RA), we measured the bone mineral density of forty patients with RA at spine, radius and calcaneus by the dual energy X-ray absorptiometry. Quantitative ultrasound was also performed to measure stiffness index of calcaneus. The
Z-score of bone density was compared to the serum levels of interleukin-6, TNF-α and intact osteocalcin, and to the activity of daily living which were separately assessed by upper or lower limb function. The effects of corticosteroid were also examined. The decrease in bone mineral density was the most prominentin calcaneus (
Z score=-1.3), and was minimal in spine (
Z score=-0.2). There was no relationships between the serum levels of cytokines or intact osteocalcin and bone mineral density except a third distal of the radius. The function of upper or lower limb correlated with the bone mineral density of respective limb. The influence of corticosteroid appeared to decrease the stiffness index of calcaneus. These results showed that disuse of the extremity was the most important factor for osteoporosis of patients with RA and that corticosteroid seemed to have relations with the quality of bone.
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