Bone microarchitecture in rheumatoid arthritis: focus on trabecular bone index

Objective: to investigate indicators of inflammatory activity and biochemical markers of bone metabolism as factors influencing bone microarchitecture, assessed by the trabecular bone index (TBI), in women with rheumatoid arthritis (RA).

Material and methods. A cross-sectional study included 124 women with verified RA (mean age 60.3±10.0 years). A survey using a proprietary questionnaire, laboratory testing, and lumbar spine (L1–IV) X-ray densitometry with determination of TBI were performed.

Results and discussion. Degraded bone microarchitecture was found in 33.9%, partially degraded in 21.8%, and normal in 44.3% of women with RA. In univariate regression analysis, age (p<0.001), duration of postmenopause (p=0.035), levels of uric acid (UA; p=0.023), alkaline phosphatase (ALP; p=0.021), anti-cyclic citrullinated peptide antibodies (anti-CCP; p=0.037), and phosphorus (=0.23; p=0.011) correlated with TBI values.

Conclusion. Normal bone microarchitecture was found in only 44.3% of women with RA. TBI was negatively associated with age, duration of postmenopause, levels of UA, ALP, and anti-CCP, and positively with phosphorus level. No correlation was observed between TBI values and indicators of RA inflammatory activity.

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