| Objective To study the influencing factors of bone mineral density (BMD) and bone metabolism in rheumatoid arthritis (RA) patients and to evaluate the influence of exercise frequency on BMD and bone metabolism in RA patients with osteoporosis (OP). Methods Retrospective analysis of BMD and serum bone metabolism index (β-CTX, PINP, OC, 25-OHD) of 45 RA patients at the first diagnosis, and the influence of gender, age, course of disease, HSCRP, ESR, anti-CCP, DAS28 score and other relevant clinical factors. Data on rehabilitation exercise of RA patients with OP were collected via telephone interview and the influence of exercise frequency on their BMD and bone metabolism index was evaluated. Results The incidence rate of RA with OP was 46.67%, and the most obvious decrease of BMD occurred at lumbar vertebra and femur neck. BMD was related to age, the course of disease and DAS28 score. BMD decreased with age, the course of disease and higher DAS28 score (P＜0.05). Bone absorption index β-CTX increased in those aged ≤65 years, those with the course of disease ≤0.5 year and those with positive anti-CCP, and the differences were statistically significant (P＜0.01, P＜0.05). Bone formation index PINP and OC increased in those aged ≤65 years and those with positive anti-CCP, and the differences were statistically significant (P＜0.05). Serum 25-OHD level in the DAS28 score＜2.6 group was higher than that in the DAS28 score ≥2.6 group, and the difference was statistically significant (P＜0.05). In RA patients with OP, BMD of whole body and lumbar vertebra, PINP and OC in the frequently exercise group were all higher than the no exercise group, and the differences were statistically significant (P＜0.05, P＜0.01). PINP, OC and frequent exercise had positive correlation (P＜0.05), and β-CTX and anti-CCP had positive correlation (P＜0.01). Multiple linear regression analysis showed that serum 25-OHD level and exercise frequency were significant predictors of whole body BMD, with the increase of serum25-OHD level and the exercise frequency, the BMD of whole body showed an increasing trend. Conclusion The incidence rate of RA with OP was high, and BMD was related to age, course of disease, disease activity, 25-OHD level and exercise frequency. RA with OP is a high conversion type bone metabolic abnormality. Bone destruction and bone formation speed up both in the initial stage of disease and the active stage of disease. Exercise promotes bone formation and increases BMD. In clinical practice, we should promote the importance of exercise therapy on the basis of medical treatment. |