Osteoporosis, bone & mineral

Risk factors for osteoporosis in rheumatoid arthritis patients: a meta-analysis

Osteoporos IntPublished Systematic review and meta-analysis

Authors' conclusion

This meta-analysis reveals female, age, postmenopausal status, prior fracture, and glucocorticoid therapy as major risk factors for osteoporosis in rheumatoid arthritis, with higher BMI as protective factors

Study context

Population
Patients with rheumatoid arthritis (RA); PubMed, Embase, Cochrane Library, Web of Science, CNKI, Wanfang, VIP and Chinese Biomedical databases from inception to December 31, 202457 articles
Outcome
Risk factors for osteoporosis (OP) in RA
Methodological detailsNewcastle-Ottawa Scale quality assessment, funnel plots and Egger's test for publication bias
  • Newcastle-Ottawa Scale quality assessment
  • Funnel plots and Egger's test for publication bias

Pooled result

As reported in the abstract

Risk factors for OP in RA (OR)
Female
OR = 2.10
Advancing age
OR = 1.11
Prior fracture
OR = 2.83
Disease duration
OR = 1.16
Postmenopausal status
OR = 3.96
Elevated CTX
OR = 1.01
Higher DAS28 scores
OR = 1.60
Increased ESR
OR = 1.05
Higher Sharp Scores
OR = 1.12
RF titers
OR = 1.01
GC therapy
OR = 2.34
Higher BMI (protective)
OR = 0.86
Adequate 25-(OH)-D levels (protective)
OR = 0.88
Calcium and/or vitamin D supplementation (protective)
OR = 0.49

Original publication

Risk factors for osteoporosis in rheumatoid arthritis patients: a meta-analysis. Osteoporos Int. Published 4 November 2025. doi:10.1007/s00198-025-07700-0

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