Stan zdrowia kości u młodych dorosłych z zapalnymi chorobami stawów: ocena czynników związanych z niską gęstością mineralną kości

RATIONALE: To evaluate bone mineral density (BMD) in young adults with inflammatory arthritis. MAIN RESULT: Low BMD was detected in 42% of patients, associated with male sex, lower BMI, slower gait speed, higher ESR, and prolonged glucocorticoids. SIGNIFICANCE: This population requires early, comprehensive bone health screening to prevent long-term complications. INTRODUCTION: Bone loss and consequent fractures significantly reduce quality of life, causing disability and premature mortality. These issues, common in elderly patients, are also linked to inflammatory arthritis (IA). The impact of IA on bone health in young adults (20-40 years) is poorly documented. This study investigated the prevalence of low bone mineral density (BMD) and potential risk factors in young adults with IA in Ukraine. METHODS: Patients aged 18-40 with IA (juvenile idiopathic arthritis (JIA), spondyloarthritis (SpA), rheumatoid arthritis (RA)) and disease duration > 2 years, observed between November 2020 and December 2022, were included in this mono-centric study. Exclusion criteria are as follows: diabetes mellitus, endoprosthesis, systemic JIA, and pregnancy. BMD was measured using dual-energy X-ray absorptiometry. Low BMD was defined as a Z-score ≤ -2.0 at the lumbar spine, total hip, or femoral neck. Multivariable logistic regression, adjusted for sex, body mass index (BMI), erythrocyte sedimentation rate (ESR), gait speed, and duration of glucocorticoid use, was performed to evaluate associated factors, calculating odds ratios (OR) with confidence intervals. RESULTS: Among 144 patients (81 females, 63 males; median age 29 years), the prevalence of low BMD was 42% (61/144): 42% in JIA, 31% in SpA, and 26% in RA. In the adjusted multivariable model, low BMD was associated with male sex (OR = 11.5, p < 0.001), lower BMI (OR = 0.74, p < 0.001), higher ESR (OR = 1.10, p < 0.001), slower gait speed (OR = 0.02, p < 0.001), and longer duration of glucocorticoid use (OR = 1.03, p = 0.003). CONCLUSIONS: Our study revealed a high prevalence of low BMD among young patients with IA in Ukraine, closely linked to disease-related factors. This condition is multifactorial and associated with a specific clinical profile, including male sex, lower BMI, reduced physical performance, higher inflammation, and prolonged glucocorticoid use, highlighting the need for comprehensive screening and care.