Objective To investigate fracture risk and related clinical risk factors in RA patients in China by using fracture risk assessment tool (FRAX). Methods Fifty-two cases of rheumatoid arthritis (RA), 47 cases of primary Sjogren's syndrome (pSS), and 41 cases of healthy participants in our hospital were enrolled into RA group, pSS group, and control group, respectively. Patients in RA group were tested for ACPA, RF, ESR and CRP. DAS28-ESR and HAQ-DI were calculated. BMD was accessed with dual energy X-ray absorptiometry. 10-Year fracture risk was evaluated with FRAX. The statistical analyses were conducted with a SPSS statistical software. Results In this study, FRAX-related fracture risk factors such as height, smoking, alcohol consumption, previous fracture, and parental fracture were not statistically different among the three groups. The cumulative days of glucocorticoid use in RA group was higher than that in pSS group (P<0.05). The risk of major osteoporotic fractures and hip fractures in the RA group was higher than that in the pSS group (P<0.05 or P<0.01), regardless of whether FRAX combined BMD or not. The risk of major osteoporotic fracture and hip fracture in RA group was higher than that in control group (P<0.05 or P<0.01) in terms of age, glucocorticoid use, and menopause, as assessed with FRAX combined with BMD evaluation. The 10-year risk incidence of major osteoporotic fractures in RA group was assessed with FRAX combined with BMD and divided into low-risk, medium-risk, and high-risk groups. The mean values of ACPA, RF, ESR, CRP, DAS28-ESR, and HAQ-DI showed an upward trend in the three groups, and the differences were statistically significant (P<0.01). Conclusion Fracture risk assessment in RA patients could be performed using FRAX combined with BMD. RA patients with long-term and high-dose use of glucocorticoids, elderly, and post-menopause should pay more attention to the assessment of fracture risk. Effective control of disease activity and improvement of joint function in RA would help to prevent osteoporotic fracture. |