| Objective To investigate the changes of bone mineral density (BMD) in postmenopausal patients with high disease activity rheumatoid arthritis (RA). Methods The general clinical data of 50 postmenopausal patients with RA was collected, including age, course of disease, menopausal age, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factors (RF), anti-cyclic citrullinated peptide antibody (anti-CCP), disease activity score in 28 joints (DSA28), and estrogen levels. BMD of the lumbar spine L1-4 and left hip was measured with dual energy X-ray absorptiometry (DXA) and was analyzed. Results 1) 50 postmenopausal patients with RA (DSA28 score> 5.1) belong to high disease activity. The incidence of osteoporosis, osteopenia, and normal bone mass in postmenopausal patients was 52%, 30%, and 18%, respectively. 2) Compared with those in non-osteoporosis group, the age of menopause was significantly advanced in osteoporosis group (P=0.005), and the level of anti-CCP increased significantly (P=0.037). There were no statistical differences of age, duration, RF, DSA28 score, and estrogen levels between the two groups. 3) Logistic regression analysis showed that anti-CCP (OR 1.025, P=0.041) was independent risk factor for osteoporosis in postmenopausal patients with high disease activity RA. 4) In osteoporosis group, the total BMD of the lumbar spine was significantly lower than that of the hip (P<0.001). Among the lumbar spines, BMD of L1 was the lowest, followed by L2, L3, and L4 (P=0.0003). In the left hip, BMD of the greater trochanter was the lowest, followed by the femoral neck and the lesser trochanter (P<0.0001). Conclusion Osteoporosis in postmenopausal patients with high disease activity RA is common. BMD of the lumbar spine (especially L1) decreased most significantly. Anti-CCP may be a risk factor for osteoporosis in postmenopausal patients with high disease activity RA. |