Usefulness of cortical thickness ratio of the third metacarpal bone for prediction of major osteoporotic fractures

• Published in: Bone Reports Vol. 16; p. 101162
• Main Authors: Yoshii, Ichiro, Sawada, Naoya, Chijiwa, Tatsumi, Kokei, Shohei
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.06.2022; Elsevier
• Subjects: Bone mineral density; Cortical thickness ratio; Fracture; Full Length; Osteoporosis; Rheumatoid arthritis; Osteoporosis; Bone mineral density; Fracture; Rheumatoid arthritis; Cortical thickness ratio
• ISSN: 2352-1872; 2352-1872
• DOI: 10.1016/j.bonr.2021.101162

Patients with rheumatoid arthritis (RA) are at high risk for osteoporotic fractures. We developed an index called the third metacarpal cortical thickness ratio (CTR), which reflects bone mineral density (BMD) in RA patients. A longitudinal study was conducted to verify the usefulness of CTR during the follow-up period. Patients with RA who underwent dual energy X-ray absorptiometry (DXA) and hand X-ray simultaneously were monitored for disease activity and activities of daily living at 3-month intervals, and BMD and CTR were measured at 1-year intervals. Mean CTR during follow-up was tested for correlation with mean BMD at both the lumbar spine (LS) and femoral neck (FN) during follow-up. Correlations were examined, including other variants potentially correlated with BMD. The risk ratio of accidental major osteoporotic fractures (MOF) in the variance including CTR and BMD was evaluated. A total of 300 patients, 40 men and 260 women, were enrolled. Mean follow-up length was 49.6 months. CTR was significantly associated with BMD in FN using a multivariate model of linear regression analysis (p < 0.0001), whereas CTR was significantly associated with BMD in LS using only a univariate model (p < 0.01). The only variant with a significantly higher risk ratio for incident MOF was the presence of prevalent MOF. CTR and BMD did not show a significantly higher risk ratio using Cox regression analysis. CTR correlated significantly with BMD even during follow-up, especially in FN. However, CTR and BMD were not risk factors for major MOF. •Correlation between cortical thickness ratio of the third metacarpal bone and incident osteoporotic fracture was evaluated.•Correlations were confirmed using longitudinal as well as cross-sectional studies.•The CTR did not show a significant higher risk ratio for the development of osteoporotic fractures, though BMD also did not•Possibility in which the RA patient causes the incidental fracture by the reason except for the bone density is indicated.