Risk factors for osteoporosis in rheumatoid arthritis patients: a meta-analysis
Abstract
Background: The purpose of this investigation was to determine risk factors for osteoporosis (OP) in patients with rheumatoid arthritis (RA) through comprehensive literature review and meta-analysis.
Methods: A comprehensive database exploration covered PubMed, Embase, Cochrane Library, Web of Science, CNKI, Wanfang, VIP, and Chinese Biomedical databases from inception to December 31, 2024. Study quality was assessed using the Newcastle-Ottawa Scale for Healthcare Research and Quality (AHRQ). Data analyses involved STATA 18 to calculate odds ratios (ORs) with 95% confidence intervals (CIs). Publication bias assessment involved funnel plots in conjunction with Egger's test.
Results: Fifty-seven articles were incorporated in the meta-analysis. Significant risk factors for OP in RA patients included female (OR = 2.10), advancing age (OR = 1.11), prior fracture (OR = 2.83), disease duration (OR = 1.16), and postmenopausal status (OR = 3.96). Laboratory and clinical parameters that correlated with increased risk included elevated CTX (OR = 1.01), higher DAS28 scores (OR = 1.60), increased ESR (OR = 1.05), higher Sharp Scores (OR = 1.12), and RF titers (OR = 1.01). Glucocorticoid therapy constituted a significant risk factor (OR = 2.34). Protective factors included higher BMI (OR = 0.86), adequate 25-(OH)-D levels (OR = 0.88), and calcium and/or vitamin D supplementation (OR = 0.49). No significant associations were found between OP in individuals with RA and smoking history,…
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