The FRAX Assessment Of Osteoporotic Fracture Risk In Rheumatoid Arthritis

Objective: Application of the world health organization (WHO) fracture riskassessment tool (FRAX) to evaluate the osteoporotic fracture risk in rheumatoid arthritispatients,Preliminary discussion the treatment threshold of osteoporotic fracture risk ofRA patients.Methods: Selected175RA patients in Yijishan Hospital of Wannan Medical CollegeRheumatology outpatient and inpatient from January2012to December2013,andcollect relevant clinical data and fracture risk indicators in patients,using the AmericanGE-lunar dual-energy X ray absorptiometry(DEXA) to measure bone density andrecord the results;application of FRAX calculated the risk of major osteoporotic fractureprobability and the probability of hip fracture risk in patients over the next10years,combining with the patient’s clinical and laboratory indexes,statistics the resultswere analyzed and compared.Results:（1）The175RApatients’ next ten years hip and major fracture probability ofFRAX were (4.02±4.32)%and (8.83±6.10)%.(2) According next decade majorosteoporotic fracture probability175cases were divided into:58in high-risk group(fracture probability≥10%)，117in the low-risk group (fracture probability <10%).High school age risk group of patients aged concentrated in60-69,70-79,low-riskgroup to40-49,50-59age-based,The high-risk age group older than low risk group,theolder the higher rate of fracture risk.(3)The major fracture risk rate of150female RApatients was (9.49±6.27)%.(4) The correlation between the main risk of osteoporoticfracture rate，osteoporotic hip fracture risk rate and bone mineral density, The main risk of osteoporotic fracture rate was negatively correlated with BMD (r=-0.767, P <0.05),osteoporotic hip fracture risk rate was negatively correlated with BMD (r=-0.771, P<0.05).(5) According to the femoral neck bone mineral density of175patients with RAwhether osteoporosis with Logistic regression analysis, the results show only the age,gender associated with the osteoporosis,there is no correlation with DAS28, RF, CRP,ESR, anti-CCP antibodies.The patient use Glucocorticoid with the incidence ofosteoporosis (31/132，23.5%) is higher than that not use group (3/43,7.0%).Conclusion: The FRAX assessment of osteoporotic fracture risk in rheumatoidarthritis is better than that of BMD alone. The region’s recommended treatmentthreshold of FRAX Assessment is7%. Older,lower BMD,using of Glucocorticoid andpostmenopausal rheumatoid arthritis patients are more likely to have osteoporosis,andthe correlation of disease activity and laboratory indexes needs further research.