Constructing a risk column chart for secondary osteoporosis in menopausal rheumatoid arthritis based on DXA
Objective To analyze the risk factors for secondary osteoporosis in menopausal rheumatoid arthritis based on the relevant parameters of Dual Energy X-ray absorptiometry(DXA),and construct a risk column chart for secondary osteoporosis in menopausal rheumatoid arthritis.Methods A retrospective analysis was conducted on 166 patients with menopausal rheu-matoid arthritis admitted to Qinghai Provincial Traditional Chinese Medicine Hospital from December 2021 to November 2023.Based on the secondary osteoporosis status of the patients,they were divided into a secondary group(76 cases)and a non second-ary group(90 cases).The general information,clinical characteristics,and DXA related parameters of the two groups were com-pared to analyze the independent influencing factors of secondary osteoporosis in menopausal rheumatoid arthritis.A risk col-umn chart model for secondary osteoporosis in patients was constructed using Rstudio 4.2.1 software,and Hosmer Lemeshow was used to verify the fit of the model.Results The results of multiple logistic regression analysis showed that age(95％CI=1.260-1.883,P＜0.001),duration of rheumatoid arthritis(95％C/=1.310-3.472,P=0.002),hip joint bone density(95％CI=0.001-0.023,P=0.001),femoral neck bone density(95％CI=0.001-0.489,P=0.024),lumbar spine bone density(95％CI=0.004-0.901,P=0.042),and bone mineral content(95％C/=0.098-0.502,P＜0.001)were all independent influencing factors of second-ary osteoporosis in menopausal rheumatoid arthritis(P＜0.05).The osteoporosis risk column chart constructed based on the above factors had a lower product of the ROC curve(AUC)of 0.976(95％C/=0.958-0.995),a maximum Youden index of 0.891,a sensitivity of 0.947,and a specificity of 0.944.It had good predictive value for the risk of postoperative secondary osteoporosis in patients.The fitting degree of the column chart constructed using Hosmer Lemeshow test was tested,and the final model H-L test had a chi square of 7.385,P=0.496,indicating good fitting degree.Conclusion Age,duration of rheumatoid arthritis,hip joint bone density,femoral neck bone density,lumbar spine bone density,and bone mineral content are all independent risk fac-tors of secondary osteoporosis in menopausal rheumatoid arthritis.The column chart model constructed based on this can accu-rately predict the risk of secondary osteoporosis in menopausal rheumatoid arthritis and has certain clinical significance.
Rheumatoid arthritisDual energy X-ray absorptionMenopauseOsteoporosisColumn chart
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