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The relationship between osteoarthritis (OA) and osteoporosis has been controversial. In a new review that was released during the American College of Rheumatology’s (ACR) annual meeting, ACR Convergence, researchers aimed to clarify the relationship between OA and osteoporosis.

“While OA may be associated with increased bone mineral density (BMD) due to increased weight, evidence exists that the incidence of [osteoporosis] may be increased in patients with OA,” the authors wrote.

Now, what they found through this study is providing answers on the relationship between these 2 conditions. According to the systematic literature review results, there is no significant difference in prevalence of osteoporosis among subjects with or without OA.

“This suggests that OA may not have protective effects on development of [osteoporosis],” the researchers wrote. “Therefore, diagnosis of OA should not preclude patients from being investigated for [osteoporosis].”

To reach this conclusion, the researcher identified articles that had analyzed the frequency, rate, prevalence, incidence, risk, or excess risk of osteoporosis among patients with OA compared with age- and sex-matched controls.

In all, 2772 unique articles were identified. Of those, 49 articles were chosen for full article screening, and 6 articles met inclusion criteria.

The articles showed that when bone mineral density (BMD) was measured at the femoral neck, hip, or lumbar spine, there was not a significant difference in osteoporosis prevalence between the OA group vs the control group, for men or women.

A subgroup analysis of men and women whose BMD was measured at the lumbar spine showed that, compared with the OA group, the control group had a higher prevalence of osteoporosis. In a subgroup analysis of only women whose BMD was measured at the lumbar spine, the difference remained significant.

“OA may present with atrophic features associated with increased frequency of osteoporotic fractures compared to OA with osteophytosis; this distinction may be important to consider for future studies,” the researchers concluded.

—Colleen Murphy

Reference:

Varghese T, Pirshahid AA, Kim D, Li Y. The prevalence of osteoporosis in individuals with osteoarthritis: a systematic review. Study presented at: American College of Rheumatology Convergence 2020; November 5-9, 2020; Virtual. Accessed October 29, 2020. https://acrabstracts.org/abstract/the-prevalence-of-osteoporosis-in-individuals-with-osteoarthritis-a-systematic-review/