Relationship between vertebral fracture prevalence and abdominal aortic calcification in women with rheumatoid arthritis

Majjad, Abderrahim; Ghassem, Mohamed A.; Toufik, Hamza; Sadni, Siham; Debbarh, Zineb; Djossou, Julien H.; El Ouardi, Najlae; Taoubane, Laila; Abouqal, Redouane; Achemlal, Lahcen; El Maghraoui, Abdellah

Affiliations

¹Department of Rheumatology, Military Hospital Mohammed V, Rabat, Morocco

²Laboratory of Biostatistics, Clinical Research and Epidemiology, Faculty of Medicine and Pharmacy, Rabat, Morocco

Abstract and keywords

Objectives: Vertebral fracture assessment (VFA)-detected abdominal aortic calcification (AAC) has been validated as an indicator of increased risk of vertebral fractures (VFs) in other populations but this relationship in rheumatoid arthritis (RA) is unclear. We assess the prevalence of AAC on VFA scans and its potential relationship with prevalent VFs in a cohort of RA women.

Methods: We enrolled 250 women with RA. VFA images, and scans of the lumbar spine and proximal femur were obtained using dual-energy x-ray absorptiometry. The presence/severity of VFs and AAC were carried out using validated approaches.

Results: AAC was detected in 95 of 250 (38%) eligible subjects and 83 (33.2%) had at least one VF. Significantly subjects with VFs had a higher AAC score (3.4 ± 3.8 versus 0.7 ± 1.4; p˂0.001) and higher prevalence of AAC than those without VFs (65% versus 26%; P˂0.001). The group with VFs tended to be older, had more menopausal women, and lower lumbar spine and total hip BMD than those without VF. They also had a long-standing disease and high DAS 28-CRP, a great steroid cumulative dose, and a high prevalence of rheumatoid factor (RF). In multivariate analyses, a significant association was noted between prevalent VFs and age of patients, RA disease activity, presence of densitometric osteoporosis, RF, and VFA-detected AAC, whereas there was no significant association with steroid cumulative dose and disease duration.

Conclusion: VFA is a convenient tool for the diagnosis of VFs and AAC. In this cohort, VFA-detected AAC was independently associated with prevalent VFs.

Keywords: Rheumatoid arthritis; Vertebral fracture assessment; Vertebral fractures; Abdominal aortic calcification; Women

Links

DOI: 10.1016/j.bone.2020.115599

PubMed: 32822872

WoS: 000601334700010

History

Received: 2020-04-25

Revised: 2020-08-13

Accepted: 2020-08-13

Online: 2020-08-18

Cited Works (4)

Year	Entry
2001	Lindsay R, Silverman SL, Cooper C, Hanley DA, Barton I, Broy SB, Licata A, Benhamou L, Geusens P, Flowers K, Stracke H, Seeman E. Risk of new vertebral fracture in the year following a fracture. JAMA. January 17, 2001;285(6):320-323.
1999	Black DM, Arden NK, Palermo L, Pearson J, Cummings SR; Study of Osteoporotic Fractures Research Group. Prevalent vertebral deformities predict hip fractures and new vertebral deformities but not wrist fractures. J Bone Miner Res. May 1999;14(5):821-828.
1993	Genant HK, Wu CY, van Kuijk C, Nevitt MC. Vertebral fracture assessment using a semiquantitative technique. J Bone Miner Res. September 1993;8(9):1137-1148.
1992	Ettinger B, Black DM, Nevitt MC, Rundle AC, Cauley JA, Cummings SR, Genant HK; The Study of Osteoporotic Fractures Research Group. Contribution of vertebral deformities to chronic back pain and disability. J Bone Miner Res. April 1992;7(4):449-456.