Dual-Energy X-Ray Absorptiometry and Evaluation of the Osteoporosis Self-Assessment Tool in Men With Rheumatoid Arthritis

Richards, J. Steuart; Peng, Justin; Amdur, Richard L.; Mikuls, Ted R.; Hooker, Roderick S.; Michaud, Kaleb; Reimold, Andreas M.; Cannon, Grant W.; Caplan, Liron; Johnson, Dannette; Hines, Anne E.; Kerr, Gail S.

doi:10.1016/j.jocd.2009.06.003

« Previous Next »Journal of Clinical Densitometry
Volume 12, Issue 4 , Pages 434-440, October 2009

Dual-Energy X-Ray Absorptiometry and Evaluation of the Osteoporosis Self-Assessment Tool in Men With Rheumatoid Arthritis

J. Steuart Richards
- Rheumatology Section, Washington DC VA Medical Center, Washington, DC, USA
- Department of Medicine, Georgetown University, Washington, DC, USA
- Address correspondence to: J. Steuart Richards, MBBS, Rheumatology Section, 151 K, Veterans Affairs Medical Center, 50 Irving St, NW, Washington, DC 20422.
Justin Peng
- Rheumatology Section, Washington DC VA Medical Center, Washington, DC, USA
- Department of Medicine, Georgetown University, Washington, DC, USA
Richard L. Amdur
- Research Service, Washington DC VA Medical Center, Washington, DC, USA
- Department of Psychiatry, Georgetown University, Washington, DC, USA
Ted R. Mikuls
- Rheumatology Section, Omaha VA Medical Center, Omaha, NE, USA
- Section of Rheumatology, University of Nebraska, Omaha, NE, USA
Roderick S. Hooker
- Rheumatology Section, VA North Texas Health Care System and University of Texas Southwestern Medical Center, Dallas, TX, USA
Kaleb Michaud
- Rheumatology Section, Omaha VA Medical Center, Omaha, NE, USA
Andreas M. Reimold
- Rheumatology Section, VA North Texas Health Care System and University of Texas Southwestern Medical Center, Dallas, TX, USA
Grant W. Cannon
- Rheumatology Section, George E. Wahlen VA Medical Center and University of Utah, Salt Lake City, UT, USA
Liron Caplan
- Rheumatology Section, Denver VA Medical Center and University of Colarado, Denver, CO, USA
Dannette Johnson
- Rheumatology Section, Jackson, MS VA Medical Center and University of Mississippi, Jackson, MI, USA
Anne E. Hines
- Rheumatology Section, Denver VA Medical Center and University of Colarado, Denver, CO, USA
Gail S. Kerr
- Rheumatology Section, Washington DC VA Medical Center, Washington, DC, USA
- Department of Medicine, Georgetown University, Washington, DC, USA

Received 27 March 2009; received in revised form 16 June 2009; accepted 17 June 2009. published online 24 September 2009.

Abstract

Males with rheumatoid arthritis (RA) are at risk for osteoporosis but infrequently undergo dual-energy X-ray absorptiometry (DXA). We examined the frequency of DXA in males enrolled in the Veterans Affairs Rheumatoid Arthritis Registry. The Osteoporosis Self-Assessment Tool (OST) index, a formula using age and weight, was calculated for all subjects. DXA was performed on 282 (35.5%) of the males who were younger (p<0.01), had lower mean OST index score (p<0.05), and were more likely to have been prescribed prednisone (p<0.01) than subjects without DXA. Low bone mass (T-score<−1) was present in 73% of subjects with DXA; 37% of subjects with low-risk OST index scores had normal bone mineral density (BMD) compared with 5.6% of those with high-risk OST index scores (p<0.01). There was a significant but modest correlation between BMD and the OST index (r=0.17, p<0.01). No OST score had a sensitivity and specificity of more than 80%. Association between OST index and BMD was strongest in non-Hispanic whites, subjects older than 60yr, and smokers. DXA was underutilized in males with RA. The OST index correlated with low bone mass but could not reliably predict osteoporosis in this population.