Archives of Osteoporosis

, 13:99 | Cite as

An epidemiological analysis of osteoporotic characteristics in patients affected with rheumatoid arthritis in Kazakhstan

  • Gulzhan Gabdulina
  • Melody Kasher
  • Aliya Beissebayeva
  • Dana Mussabaeva
  • Alexander Tokarev
  • Gulmira Mominova
  • Gulnar Essirkepova
  • Ainash Amanzholova
  • Korlan Zaurbekova
  • Maira Saparbaeva
  • Maira Bizhanova
  • Moldir Kulshymanova
  • Gregory LivshitsEmail author
Original Article



We aimed to assess which of the major risk factors associated with rheumatoid arthritis (RA) severity are also associated with osteoporosis-related phenotypes (OP-RP) in the native population of Kazakhstan.


Four hundred six RA patients (90.6% females) with 397 controls—unaffected first-degree relatives were recruited. Biochemical factors were recorded, and OP-RP were assessed using QCT scans and ultrasound densitometry (US) of the forearm to estimate cortical indices (CI), spongial bone mineral density (BMDSPN), and US_T-scores.


In the RA affected female population, ~ 80% suffered from osteopenia or osteoporosis. All OP-RP were negatively correlated with age and female’s sex, as expected, and thus accordingly adjusted, resulting in consistent, significantly [p = 0.016 (CI), p < 0.0001 (both BMDSPN and US_T-scores)] lower OP-RP estimates in affected females. Using multiple regression analysis for OP-RP manifestations, only age and disease duration appeared consistently associated with all three studied phenotypes, while menopause status or years following the onset of menopause were also significant for BMDSPN and US_T-scores. However, when disease duration was examined, we found that it was significantly dependent on morning stiffness, ESR, total cholesterol levels, weight, and menopause status, which explains 38.6% of the disease duration.


Approximately 80% of female RA patients suffer from osteoporosis or osteopenia in the study group, which appears from a young age. RA disease duration is the major risk factor for OP-RP deterioration, especially as assessed by BMDSPNG, and US_T-scores. As a result, all OP-RP demonstrate significantly lower levels in comparison to sex- and age-matched unaffected individuals.


Rheumatoid arthritis Bone mineral density (BMD) Cortical index US_T-score Osteoporosis Risk factors 



Anti-citrullinated protein antibody


Alanine transaminase


Aspartame transaminase


Bone mineral density of the medullar compartment of ulna


Body mass index


Bone cortical index


Averaged cortical index of ulna and radius


C-reactive protein


Erythrocyte sedimentation rate


Blood glucose levels




High density lipoprotein


Heart rate




Low-density lipoprotein


Osteoporosis-related phenotypes


Rheumatoid arthritis


Rheumatoid factor


Systolic blood pressure/diastolic blood pressure


Total cholesterol


Ultrasound T-criterion (US TC)


Ultrasound Z-criterion (US ZC)


Waist hip ratio




Funding information

The study was supported by Kazakhstan Ministry of Education and Science (grant № 2460/ГФ4, registration number 0115РК00901)

Supplementary material

11657_2018_514_MOESM1_ESM.docx (127 kb)
ESM 1 (DOCX 127 kb)


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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2018

Authors and Affiliations

  • Gulzhan Gabdulina
    • 1
  • Melody Kasher
    • 2
    • 3
  • Aliya Beissebayeva
    • 4
  • Dana Mussabaeva
    • 4
  • Alexander Tokarev
    • 4
  • Gulmira Mominova
    • 4
  • Gulnar Essirkepova
    • 4
  • Ainash Amanzholova
    • 1
  • Korlan Zaurbekova
    • 4
  • Maira Saparbaeva
    • 1
  • Maira Bizhanova
    • 1
  • Moldir Kulshymanova
    • 1
  • Gregory Livshits
    • 2
    • 3
    Email author
  1. 1.Department of General Medical PracticeKazakh National Medical UniversityAlmatyKazakhstan
  2. 2.Human Population Biology Research Unit, Department of Anatomy and Anthropology, Sackler Faculty of MedicineTel Aviv UniversityTel-AvivIsrael
  3. 3.Lilian and Marcel Pollak Chair of Biological Anthropology, Sackler Faculty of MedicineTel Aviv UniversityTel Aviv-YafoIsrael
  4. 4.City Rheumatology Center of AlmatyAlmatyKazakhstan

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