Tragl S, Manger E, Niemiec LM, Coppers B, Bayat S, Kleyer A, Simon D, Tascilar K, Rech J, Schett G, Hueber A, Liphardt AM (2025)
Publication Type: Journal article
Publication year: 2025
Book Volume: 84
Pages Range: 1339-1340
DOI: 10.1016/j.ard.2025.06.645
Background:
Patients with inflammatory arthritis also suffer from bone loss [1]. While it is generally known that bone morphology is related to physical function this interaction is not well understood in the context of rheumatic disease.
Objectives:
To investigate the relation of hand function with bone mineral density and bone morphology at the radius in rheumatoid arthritis (RA) patients compared to health controls.
Methods:
This cross-sectional study was performed with RA patients and healthy controls in the Outpatient clinics of the Internal Medicine 3 at the Uniklinikum Erlangen, Germany, after obtaining written informed consent of the participants. Three components of hand function were assessed: grip strength (Lafayette Hydraulic Dynamometer, pounds (lbf)), dexterity grip (Moberg Picking Up Test, seconds (s)) and patient-perceived hand function (Michigan Outcome Questionnaire, score). Bone morphology of the distal radius (arm affected by RA or dominant side) was assessed by high-resolution peripheral quantitative computed tomography (XtremeCT 1, Scanco Medical, Brüttisellen, Switzerland) at 82 µm resolution. The following parameters were analysed: Total (Tt.) bone mineral density (BMD, mg HA/cm³), Trabecular (Tb.) BMD (mg HA/cm³), Cortical (Ct.) BMD (mg HA/cm³), bone volume (BV)/ total volume (TV, %), Tb. Number (N, 1/mm), Tb. Thickness (Th, mm), Tb. Separation (Sp, mm), Tb. Are (Ar, mm²), Ct.Th (mm), Ct.Ar (cm²), estimated Failure Load (N). Hand function outcome parameters were correlated with bone parameters using Pearson-Correlation coefficient (r). Multiple linear regression models were used to identify predictors of bone parameters.
Results:
Eighty-eight RA patients (mean age 59.1 (± 13.3 SD); mean body mass index (BMI) 27.2 (± 5.0 SD) kg/m²) and 30 healthy controls (mean age 54.6 (± 16.5 SD); mean BMI 25.2 (± 3.2 SD) kg/m²) were included in this analysis. Bone parameters are summarized in Table 1. Overall, grip strength correlated positively (p <.01 for all) with Tt. BMD (r=.33, Tb. BMD (r =.47), BV/TV (r =.47), Tb.N (r = 0.39), Tb.Th (r =.29), Tb.Ar. (r =.44) and Ct.Ar. (r =.48) and negatively with Tb.Sp (r = -.34). No correlation between MPUT completion time and perceived hand function was observed. Rheumatoid factor positivity, age, sex BMI, MPUT and grip strength accounted for 26% (corrected R²) of the variation in Tt.BMD. Rheumatoid factor positivity, age and BMI were significant predictors. The same variables accounted for 32% of the variation in Tb.BMD with sex, grip strength and BMI as significant predictors, whereas only rheumatic factor positivity and age were significant predictors of Ct. BMD.
Conclusion:
Grip strength, but not fine motor skills (assessed by MPUT) or perceived hand function, is related to trabecular bone morphology in RA patients and healthy controls. Higher grip strengths is associated with thicker trabeculae and lower trabecular separation. The association between grip strength and bone structure likely reflect a common cumulative consequence of RA on muscle mass and bone structure.
APA:
Tragl, S., Manger, E., Niemiec, L.M., Coppers, B., Bayat, S., Kleyer, A.,... Liphardt, A.-M. (2025). POS1296 BONE MORPHOLOGY IS RELATED WITH HAND FUNCTION IN PATIENTS WITH RHEUMATOID ARTHRITIS. Annals of the Rheumatic Diseases, 84, 1339-1340. https://doi.org/10.1016/j.ard.2025.06.645
MLA:
Tragl, Sonja, et al. "POS1296 BONE MORPHOLOGY IS RELATED WITH HAND FUNCTION IN PATIENTS WITH RHEUMATOID ARTHRITIS." Annals of the Rheumatic Diseases 84 (2025): 1339-1340.
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