Journal
BONE REPORTS
Volume 12, Issue -, Pages -Publisher
ELSEVIER
DOI: 10.1016/j.bonr.2020.100284
Keywords
Frailty; Bone mineral density; Sex differences; Body composition
Categories
Funding
- Rheumatology Research Foundation's Scientist Development Award
- Rosalind Russell/Ephraim Engleman Arthritis Research Center
- UCSF Core Center for Musculoskeletal Biology and Medicine (CCMBM) of the National Institutes of Health's National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) [P30AR066262]
- National Institutes of Health [P60 AR053308]
- Department of Veterans Affairs
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Objectives: Frailty in the general population is associated with poor health outcomes including low bone mass and osteoporotic fracture. The relationship between frailty and low bone mineral density (BMD) in rheumatoid arthritis (RA) is unknown. This study examined associations between frailty and BMD in RA, controlling for established osteoporosis risk factors. Methods: We performed a cross-sectional analysis of a longitudinal RA cohort (n = 138; 117 female, 21 male). Participants fulfilled ACR RA classification criteria. Frailty was evaluated using the Fried Index, categorizing each participant as robust, pre-frail or frail. To identify independent predictors of BMD, we performed a multivariable linear regression analysis. Because risk factors for low BMD differ between sexes, we performed additional sex-stratified multivariable analyses. Results: Mean age and disease duration were 58.0 +/- 10.8 and 19 +/- 10.9 years, respectively. The majority of participants were categorized as pre-frail (70%) or frail (10%). Females had higher rates of frailty than males. In the whole cohort, both pre-frail and frail had independent negative associations with BMD (beta = -0.074 and -0.092 respectively, p < 0.05). In sex-stratified analyses, frailty did not have a significant association with BMD in females, but had a strong independent negative association in males (beta = -0.247, p = 0.001). Conclusion: Frailty was associated with BMD in patients with RA. Females had higher rates of frailty than males, yet frailty was independently associated with BMD in males but not in females. Frailty appears to be an important factor associated with low BMD; sex may influence this relationship in RA.
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