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Fractures and rheumatoid arthritis: frequency and clinical assessment of associated risk factors in Chinese patients

Yang Feng, Shu-Ju Wei , Zhao-Qing Zhang, Ting-Zhen Yan

Background and aim: To determine the frequency of vertebral and non-vertebral fractures in Chinese male patients with Rheumatoid Arthritis (RA) and to evaluate the associated risk factors.

Materials and methods: A total of 798 men with RA were included in this prospective cohort study from August 2009 to September 2014. Patients were categorized based on vertebral fracture, non-vertebral fracture and no fracture. The risk factor associations were evaluated by proportional hazards models.

Results: The analysis showed 1.07 fold increase in non-vertebral fractures with age (Hazards Ratio [HR], 1.07; confidence interval [CI] 1.02 - 1.16), 0.6 fold with CRP levels (HR, 0.61; CI 0.39 - 0.97), and 6.04 fold with total knee replacement [TKR] history (HR, 6.04; CI 1.16-29.90). With regards to vertebral fractures, 1.16 fold increase with age (HR, 1.16; CI 1.00-1.30), 3.32 fold with orthopedic surgery history (HR, 3.32; CI 1.66-8.12) and 7.62 fold with Chinese Health Assessment Questionnaire (HAQ) score (HR, 7.62; CI 2.66-28.90) was noted.

Conclusion: Age, low CRP levels and TKR history were found to be risk factors for non-vertebral fractures whereas age, history of orthopedic surgery and high Chinese HAQ scores as risk factors for vertebral fracture.