Frequency of osteoporosis in 187 men with rheumatoid arthritis followed in a university hospital

Although there is relevant information on frequency of osteoporosis in women with rheumatoid arthritis (RA), data about male patients are limited. We evaluated the frequency of osteoporosis in a group of Spanish men with RA followed in a university hospital.From the database of our bone densitometry unit, we searched for men with RA evaluated between January 1991 and December 2004 and identified 187 patients, 156 of whom were older than 50 years. Previously recorded demographic, disease, and treatment-related variables were collected. Bone mineral density (BMD) was measured by dual x-ray absorptiometry (DEXA). Osteoporosis was defined according to the criteria of the World Health Organization (WHO), recommended for postmenopausal Caucasian women, as a T scoreor= -2.5 SD, and the International Society for Clinical Densitometry (ISCD), which indicates the same diagnostic threshold, but only in men over age 50 years.BMD was lower than in the general population in both lumbar spine [Z score -0.41 +/- 1.00 (95% CI -0.55 to -0.26)] and femoral neck [Z score -0.46 +/- 0.95 (95% CI -0.60 to -0.31)]. When the WHO threshold for postmenopausal women was applied, frequency of osteoporosis was 13% at lumbar spine, 12% at the femoral neck, and 21% in at least one of the evaluated sites. When ISCD criteria were applied, the frequency of osteoporosis was 13%, 14%, and 23%, respectively.Frequency of osteoporosis in men is considerably lower than that traditionally established in women with RA, independent of the diagnostic criteria applied.