Frequency of osteoporosis in Chinese patients with rheumatoid arthritis: a meta-analysis

Objective To evaluate the current frequency of osteoporosis (OP) in Chinese patients with rheumatoid arthritis (RA) through meta-analysis. Methods The databases of PubMed, Web of Science, Cochrane Library, CNKI, Wan Fang, CBM, and VIP were searched for relevant literature regarding the occurrence of OP in Chinese patients with RA from January 1, 2000, to September 15, 2022. The literature was screened using inclusion and exclusion criteria, and qualifying articles were subjected to data extraction, quality evaluation, and meta-analysis using Stata 17.0 software. Results Altogether, 44 publications were included in this study, with a total sample size of 12,264 RA cases and 4532 patients with OP. Meta-analysis revealed that the frequency of OP in patients with RA was 37.67% [95% CI: 34.38%, 40.97%], while subgroup analysis showed that the frequency in South China was 49.43% [95% CI: 40.53%, 58.32%]. Also, the frequency in men was 29.29% [95% CI: 22.42%, 36.16%], which was significantly lower than in women (41.89% [95% CI: 36.87%, 46.90%]). The incidence rate in pre-menopausal women was only 15.19% [95% CI: 8.79%, 21.59%], much lower than the figure of 54.29% [95% CI: 45.28%, 63.30%] for post-menopausal women. Additionally, the frequency rates in the low, intermediate, and high disease activity groups were 24.52% [95% CI: 11.52%, 37.52%)], 27.67% [95% CI: 13.50%, 41.85%], and 57.96% [95% CI: 37.35%, 78.56%], respectively. Conclusion The frequency of OP in the Chinese RA population is higher than the world average, and patients with RA should receive standardized anti-RA therapy at an early stage, with emphasis on bone health in postmenopausal women, patients with high disease activity or longer disease duration.