BONE MINERAL DENSITY AND TRABECULAR BONE SCORE IN WOMEN WITH RHEUMATOID ARTHRITIS

Povorozniuk V.V. ¹, Hans D.², Karasevska T.A.³, Dzerovych N.I.¹

• ¹ДУ «Інститут геронтології ім. Д.Ф. Чеботарьова НАМН України», Київ
• ²Центр захворювань кісткової тканини, Університет госпіталю Лозанни, Лозанна, Швейцарія
• ³O.O. Bohomolets National Medical University, Kyiv

Summary. Summary. The article is a study of trabecular bone score in women with rheumatoid arthritis. 134 women with RA were examined (age — 52.4±12.7 years; height — 162.6±6.4 cm, weight — 68.5±13.8 kg, duration of disease — 9.1±7.6 years). To study the effect of age on the structural and functional state of bone tissue, the examined patients with RA were divided into five groups as for decades they belonged to. While assessing the effect of glucocorticoids (GCs) on trabecular bone score (TBS) and bone mineral density (BMD) the women fell into three groups: first group, G1 — 37 patients who did not use GCs; second, G2 — 47 patients who took GCs only at the exacerbated stage for less than 6 months; third one, G3 — 50 patients who used GCs in a dose of more than 5 mg of prednisolone for more than 3 years. BMD of PA lumbar spine, proximal femur and forearm were measured using the DXA method («Prodigy, GEHC Lunar», Madison, WI, USA). PA spine TBS was assessed by means of TBS iNsight software package installed on the DXA machine («Med-Imaps», Pessac, France). We have observed a significant decrease of TBS in the 50 year-old women with RA as compared to the women aged 30–39 years (1.156±0.140 vs 1.318±0.155; t=3.5; p=0.001). The same was true of BMD of other skeletal parts. GCs were associated with deteriorating bone quality. We have found the TBS of L_І–L_IV to be significantly lower in the patients who are systemic GC users (G3 compared to G1: 1.147±0.168 vs 1,250±0.135; t=-3.07; p=0.003), along with significant variations of the lumbar spine and femur BMD. The spine TBS of L_І–L_IV decreased by 1.4% after one year in G1 and by 5.8% in G3. Thus, the TBS of L_І–L_IV determines the bone state and must be monitored to assess the GC effect on bone tissue and dynamics of bone loss subsequent to GC treatment.