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Bone Mineral Density and Clinical Hand
Osteoarthritis in Elderly Men and Women:
The Rancho Bernardo Study
DIANE L. SCHNEIDER, ELIZABETH BARRETT-CONNOR, DEBORAH J. MORTON, and MICHAEL WEISMAN
ABSTRACT. Methods. BMD was measured by dual energy x-ray absorptiometry at the hip, lateral and anteroposterior (AP) lumbar spine, and total body. Both hands of each subject were systematically examined for bony enlargement, swelling, and deformity. Results. Using the American College of Rheumatology criteria for epidemiologic studies, the clinical diagnosis of hand OA was made in 6.6% of men and 14.5% of women. In women, BMD measurements adjusted for age, body mass index, smoking, alcohol, exercise, and current estrogen use were significantly lower only at the hip in those with versus those without hand OA. In contrast, men with hand OA had higher multiply-adjusted mean BMD levels at all sites compared to those without hand OA. These differences were statistically significant only at the AP spine; the absent difference for lateral spine BMD suggests that degenerative changes may explain the higher AP spine BMD levels. Patterns in both men and women were similar in those with isolated hand OA or hand OA in the presence of knee or hip OA. Conclusion. OA was not associated with increased BMD levels in men or women. Contrary to expectations the only significant difference was that women with hand OA had lower hip BMD. Thus evaluation for osteoporosis should not be overlooked in women with hand OA. (J Rheumatol 2002;29:1467-72) Key Indexing Terms:
HAND OSTEOARTHRITIS
From the Departments of Medicine and Family and Preventive Medicine, University of California, San Diego, La Jolla, California, USA. Supported by grant AG 07181 from the National Institute on Aging. D.L. Schneider, MD, MSc, Department of Medicine; E.L. Barrett-Connor, MD; D.J. Morton, PhD, Department of Family and Preventive Medicine, University of California, San Diego; M. Weisman, MD, Cedars-Sinai Medical Center, Los Angeles, CA. Address reprint requests to Dr. E. Barrett-Connor, Department of Community and Family Medicine, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0607. Submitted May 14, 2001; revision accepted January 31, 2002. |