Increased Risk Of Osteoporosis – Asian Women Osteoporosis

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Increased Risk Of Osteoporosis – Asian Women Osteoporosis

Bone Health in Asian Women with Rheumatoid Arthritis

Increased Risk Of Osteoporosis - Asian Women Osteoporosis
Increased Risk Of Osteoporosis – Asian Women Osteoporosis

The demographic shift with the aging of the population in Asia, especially in developing countries, has led to a marked increase in the disease burden of osteoporosis. At the same time, osteoporosis has emerged as an important, albeit neglected, an extra-articular problem in inflammatory rheumatic diseases such as rheumatoid arthritis (RA). The bone loss in RA is multifactorial in origin.

Factors influencing bone mass in RA include

  • patient gender,
  • menopausal status,
  • reduced mobility,
  • disease activity,
  • duration of disease,
  • lack of physical activity,
  • and the concomitant use of corticosteroids.

Ethnicity affects bone density, bone quality, and fracture risk. Data on bone health in Asian women with RA are limited. This review summarizes the information available and outlines the challenges encountered in Asia.

Increased Risk Of Osteoporosis - Asian Women Osteoporosis
Increased Risk Of Osteoporosis – Asian Women Osteoporosis

Osteoporosis is “a skeletal disorder characterized by compromised bone strength predisposing to an increased risk of fracture.”

With the rapid aging of the Asian population, osteoporosis has emerged as one of the most prevalent and costly health problems.

Hip fractures are major contributors to the morbidity and mortality of osteoporosis.

The number of osteoporotic fractures worldwide is expected to increase by more than three-fold over the next 50 years, with the major increase occurring outside Europe and the US, particularly in Asia and Latin America.

Increased Risk Of Osteoporosis – Asian Women Osteoporosis

Rheumatoid arthritis (RA) is the most common inflammatory polyarthritis encountered in clinical practice. The prevalence in developing countries in Asia ranges from 0.2 to 1.2%.3 The clinical spectrum of RA is, however, no different from that reported in the west.

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Patients usually present late in the course of the disease and the use of complementary and alternative medicine is very high.4 Corticosteroids are used indiscriminately, often surreptitiously in the garb of indigenous medicines.

Osteoporosis is common in systemic rheumatic diseases, including RA. There is almost a two-fold increase in osteoporosis in patients with RA, with a doubling of hip fracture risk.

Bone involvement in RA is by way of erosions, periarticular osteopenia, and generalized osteoporosis involving the axial and appendicular skeleton. Unlike post-menopausal osteoporosis, osteoporosis associated with RA is characterized by relatively preserved bone mass in the axial skeleton and marked loss in the peripheral bone.

Multiple factors influence bone health in RA: patient gender, menopausal status, reduced mobility, disease activity, duration of disease, lack of physical activity, and the concomitant use of corticosteroids.

Articular symptoms dominate the clinical picture in RA. Osteoporosis more often than not gets overlooked. This review focuses on bone health in Asian women with RA.

Increased Risk Of Osteoporosis - Asian Women Osteoporosis
Increased Risk Of Osteoporosis – Asian Women Osteoporosis

 

Increased Risk Of Osteoporosis – Asian Women Osteoporosis

This subject has recently been reviewed by Handa and colleagues. The epidemiological information on osteoporosis and fragility fractures in Asia is sparse; dual-energy X-ray absorptiometry (DEXA) availability is limited in most parts of Asia; population-specific normative data for bone density are lacking: parity, lactation, nutritional status, occupation, and ethnicity are some of the factors that affect bone mineral density (BMD) in this region; and vitamin D deficiency is a widespread problem. The available data, nonetheless, suggest that osteoporosis is not uncommon.

The results of the Asian Osteoporosis Study, the first multicenter epidemiological study conducted in Asia, confirmed that the hip fracture incidence rates in Hong Kong and Singapore were approaching those observed in American Caucasians.
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