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首页> 外文期刊>Rheumatology >Fall-related risk factors and osteoporosis in women with rheumatoid arthritis.
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Fall-related risk factors and osteoporosis in women with rheumatoid arthritis.

机译：类风湿关节炎妇女的秋季相关危险因素和骨质疏松症。

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BACKGROUND: Rheumatoid arthritis (RA) is associated with an increased risk of osteoporotic fractures. Whilst numerous studies have demonstrated low bone density in RA, few studies have examined the risk of falling, which is another major contributor to the pathogenesis of fractures (particularly hip fractures). OBJECTIVES: The aim of this study was to see if fall risk is increased in women with RA, define high-risk subgroups, and determine what proportion of women have increased risk of hip fracture due to osteoporosis and due to increased fall risk. METHODS: We performed a case-control study of older women with RA (n = 103) compared with women without RA referred for open access bone densitometry (n = 203). We measured bone density using dual-energy X-ray absorptiometry and fall risk factors (visual acuity, ability to perform standups, and heel-toe walking). RESULTS: More women with RA gave a history of a previous fall compared with controls (54 vs 44%), although this was just short of being statistically significant (difference 10%, 95% CI -2 to 22). Women with RA were more likely to have abnormal heel-toe walking and inability to perform standups compared with controls (P<0.001); however, visual acuity was similar between cases and controls. Femoral neck osteoporosis was found in 31% and increased fall risk in 68% of women with RA. Women with RA who underperformed in heel-toe walking and were unable to do standups had significantly higher ESR, Health Assessment Questionnaire score and tender joint count. RA symptoms/signs localized to the knees and ankles were more likely to be associated with the presence of fall risk factors. CONCLUSIONS: Fall-related risk factors predictive of hip fracture are common in women with RA. Fall risk needs to be considered when RA patients are being treated for osteoporosis and further work needs to be done to help reduce the risk of falling and fracture in women with RA.
机译：背景：类风湿关节炎（RA）与骨质疏松性骨折的风险增加有关。尽管许多研究表明RA的骨密度低，但很少有研究检查跌倒的风险，这是导致骨折（尤其是髋部骨折）发病机理的另一个主要因素。目的：本研究的目的是观察患有RA的女性的跌倒风险是否增加，确定高风险的亚组，并确定有多少比例的妇女因骨质疏松和跌倒风险增加而发生髋部骨折的风险增加。方法：我们进行了一项病例对照研究，比较了患有RA的老年妇女（n = 103）和未接受RA的妇女进行开放式骨密度测定（n = 203）。我们使用双能X线骨密度仪和跌倒危险因素（视力，站立姿势和脚趾走路）测量了骨密度。结果：与对照组相比，有更多RA的女性曾有过先前的跌倒史（54％vs 44％），尽管这在统计学上尚不明显（差异为10％，95％CI -22至22）。与对照组相比，RA妇女更容易出现脚跟脚趾异常行走和无法站立站立的情况（P <0.001）。然而，病例和对照之间的视敏度相似。患有RA的女性中31％发现了股骨颈骨质疏松，而68％的女性跌倒风险增加。 RA的妇女在脚趾脚趾行走中表现不佳且无法站立站立时，其ESR，健康评估问卷得分和关节压痛明显增加。 RA症状/体征仅限于膝盖和脚踝，更可能与跌倒危险因素有关。结论：RA患者中与摔倒相关的危险因素可预测髋部骨折。在对RA患者进行骨质疏松症治疗时，需要考虑跌倒的风险，并且需要做进一步的工作来帮助降低RA患女性跌倒和骨折的风险。

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