J Rheum Dis 2017; 24(1): 35-42
Published online February 28, 2017
© Korean College of Rheumatology
Correspondence to : Kichul Shin, Division of Rheumatology, Department of Internal Medicine, SMG-SNU Boramae Medical Center, 20 Boramae-ro 5-gil, Dongjak-gu, Seoul 07061, Korea. E-mail:kideb1@snu.ac.kr
This is a Open Access article, which permits unrestricted non-commerical use, distribution, and reproduction in any medium, provided the original work is properly cited.
Objective. Osteoporosis (OP) is one of the principal comorbidities in women with rheumatoid arthritis (RA). Proper nutrition for these patients is required not only to improve bone health but to better manage their chronic illness. Thus, our aim was to assess the status of key nutrient intake in postmenopausal RA women with OP. Methods. Using cross-sectional data of 4,933 postmenopausal women in the Korean National Health and Nutrition Examination Survey (K-NHANES IV, V) conducted between 2008 and 2011, we investigated the daily nutrient intake in RA subjects and their bone mineral density (BMD). We examined the association of nutrient intake and BMD after adjusting age, level of education, body mass index, family history, alcohol use, and total calorie intake in the osteoporosis, osteopenia, and normal BMD group using multivariable linear regression. Results. We included 222 RA women and 320 controls whose BMD and T-score data were available. Low calcium and phosphorous intake were associated with reduced BMD T-scores in postmenopausal RA women. Additionally, β-carotene, potassium, riboflavin, and vitamin C intake were significantly lower in RA women with OP. Multivariable linear regression analysis showed a strong positive association of intake of β-carotene, potassium, riboflavin, and calcium with higher T-scores at the lumbar spine, femur neck, and total hip (all p<0.0001, respectively). Conclusion. We found insufficient intake of nutrients such as β-carotene, potassium, riboflavin, and vitamin C in Korean postmenopausal RA women with low BMD. Dietary counseling and recommendations are warranted for these subjects to attain better bone health.
Keywords Bone density, Nutrition surveys, Osteoporosis, Rheumatoid arthritis
J Rheum Dis 2017; 24(1): 35-42
Published online February 28, 2017 https://doi.org/10.4078/jrd.2017.24.1.35
Copyright © Korean College of Rheumatology.
Yeon Soo Baik1, Jee Won Park1, Jihye Kim2, Won Gyoung Kim3, Sohee Oh4, Sung-il Cho5, Yeong Wook Song6, Kichul Shin2
1Department of Epidemiology, UCLA Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA, 2Division of Rheumatology, Department of Internal Medicine, SMG-SNU Boramae Medical Center, Departments of 3Nutrition Service and 4Biostatistics, SMG-SNU Boramae Medical Center, 5Graduate School of Public Health, Seoul National University, 6Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
Correspondence to:Kichul Shin, Division of Rheumatology, Department of Internal Medicine, SMG-SNU Boramae Medical Center, 20 Boramae-ro 5-gil, Dongjak-gu, Seoul 07061, Korea. E-mail:kideb1@snu.ac.kr
This is a Open Access article, which permits unrestricted non-commerical use, distribution, and reproduction in any medium, provided the original work is properly cited.
Objective. Osteoporosis (OP) is one of the principal comorbidities in women with rheumatoid arthritis (RA). Proper nutrition for these patients is required not only to improve bone health but to better manage their chronic illness. Thus, our aim was to assess the status of key nutrient intake in postmenopausal RA women with OP. Methods. Using cross-sectional data of 4,933 postmenopausal women in the Korean National Health and Nutrition Examination Survey (K-NHANES IV, V) conducted between 2008 and 2011, we investigated the daily nutrient intake in RA subjects and their bone mineral density (BMD). We examined the association of nutrient intake and BMD after adjusting age, level of education, body mass index, family history, alcohol use, and total calorie intake in the osteoporosis, osteopenia, and normal BMD group using multivariable linear regression. Results. We included 222 RA women and 320 controls whose BMD and T-score data were available. Low calcium and phosphorous intake were associated with reduced BMD T-scores in postmenopausal RA women. Additionally, β-carotene, potassium, riboflavin, and vitamin C intake were significantly lower in RA women with OP. Multivariable linear regression analysis showed a strong positive association of intake of β-carotene, potassium, riboflavin, and calcium with higher T-scores at the lumbar spine, femur neck, and total hip (all p<0.0001, respectively). Conclusion. We found insufficient intake of nutrients such as β-carotene, potassium, riboflavin, and vitamin C in Korean postmenopausal RA women with low BMD. Dietary counseling and recommendations are warranted for these subjects to attain better bone health.
Keywords: Bone density, Nutrition surveys, Osteoporosis, Rheumatoid arthritis
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