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Hand osteoarthritis is associated with a better bone microarchitecture in postmenopausal women: the ofely study

2019; Elsevier BV; Volume: 27; Linguagem: Inglês

10.1016/j.joca.2019.02.347

1522-9653

Elisabeth Sornay‐Rendu, F. Duboeuf, Roland Chapurlat,

Medical and Biological Sciences

Purpose: Hand osteoarthritis (OA) is one of the most common localization of OA affecting predominantly women. Several cross-sectional studies have shown that OA is associated with higher areal BMD but little is known for its relationship with bone microarchitecture (MA). The aim of this study was to investigate the association between hand OA with bone MA assessed by high resolution peripheral quantitative tomography (HR-pQCT) along with incident fragility fracture in postmenopausal women. Methods: Clinical hand OA was assessed according to the ACR criteria, in 498 postmenopausal women (mean age 64±4 yr) at the 13th annual follow-up of the ongoing prospective OFELY study, one year before the measurement of bone MA at the distal radius and tibia with HR-pQCT (XTreme CT, Scanco Medical AG, Bassersdorf, Switzerland) in addition to areal BMD with DXA. Fragility fractures (Fx) were prospectively and annually reported since the inclusion in the study (previous Fx) and after the 13th visit (incident Fx) and were all radiographically confirmed. Results: Women with hand OA (n=148), were not significantly different for age (68±8yr) and BMI (24±4) compared with women with no hand OA (n=369, 68±9 yr, 24±4). Women with hand OA had significantly greater total and trabecular (Tb) volumetric densities (vBMD),Tb distribution (TbSpSD), stiffness (K) and estimated failure load (FL) at both sites, and Tb number (TbN) at the radius, compared with women with no hand OA. No significant differences were observed for cortical (Ct) parameters (CtvBMD, Ct thickness and porosity). After adjustment for age and BMI, each SD increase of trabecular and strength parameters (Tt.vBMD, Tb.vBMD, FL and K at both sites and Tb.N at the radius) was significantly associated with an increased risk of hand OA with adjusted ORs between 1.32 and 1.51 (p=0.02 to p=0.003). For comparison, each T score increase of Total Hip aBMD was associated with an increased risk of hand OA with an adjusted OR of 1.23 (p=0.05). During a median[IQ] 10[1.1] yr of follow-up, 138 women sustained an incident fragility Fx. After adjustment for age, BMI, previous Fx and Total Hip BMD, no significant association was found between hand OA and the risk of incident Fx (adjusted hazard ratio [95%IC] of 0.93 [0.64-1.35]. Conclusions: Hand OA is associated with a better bone MA in postmenopausal women, particularly for trabecular compartment and strength. The absence of a protective effect from incident fragility fractures despite improved BMD and architecture suggests an impairment in other aspects of bone quality.