FRAX-based intervention thresholds in eight Eurasian countries: Armenia, Belarus, Georgia, Kazakhstan, the Kyrgyz Republic, Moldova, the Russian Federation, and Uzbekistan.

Age-specific intervention and assessment thresholds based on FRAX® were developed for eight Eurasian countries participating in the EVA study (Armenia, Belarus, Georgia, Moldova, Kazakhstan, the Kyrgyz Republic, the Russian Federation, and Uzbekistan). The intervention thresholds (major osteoporotic fracture) ranged from 3.6 (Armenia and Georgia) to 12.3% (Uzbekistan) for people at age 50 years, and from 16 (Armenia) to 27% (Belarus) at the age of 90 years. These thresholds enable a substantial advance in the ease of detection of individuals at high fracture risk. INTRODUCTION: The purpose of this study was to derive and compare FRAX-based intervention and BMD assessment thresholds for 8 Eurasian countries in the EVA study. METHODS: The intervention threshold (IT) was set at a 10-year probability of a major osteoporotic fracture (MOF), calculated without BMD, equivalent to a woman with a prior fragility fracture but no other clinical risk factors, and a body mass index (BMI) of 25.0 kg/m2. The lower assessment threshold was set at a 10-year probability of a MOF in women with BMI of 25.0 kg/m2, without previous fracture or other clinical risk factors. The upper assessment threshold was set at 1.2 times the IT. RESULTS: The age-specific intervention thresholds ranged from 3.6 (Armenia and Georgia) to 12.3% (Uzbekistan) for men and women at the age of 50 years and from 16 (Armenia) to 27% (Belarus) at the age of 90 years. The difference between countries was most evident at younger ages and become progressively less with advancing age. CONCLUSIONS: For the 8 Eurasian countries, the newly established FRAX-based intervention thresholds provide an opportunity to improve the clinical detection of both men and women with a high risk of fracture and improve treatment rates.

Rheumatoid arthritis is associated with exacerbated body composition deterioration in Kazakh females.

OBJECTIVE: The aim of this study was to assess the magnitude of changes in nutritional body composition components as a consequence of rheumatoid arthritis (RA) and the extent to which these components are associated with RA clinical characteristics, serologic markers, and osteoporosis-related phenotypes (OP-RPs). Early pathologic signs, if detected, could assist in future preventative techniques. METHODS: The study sample was comprised of 260 women with RA and 168 first-degree female relatives without RA who returned for body composition measurements using bioelectrical impedance analysis, from a previously established epidemiologic study conducted in Kazakhstan. RESULTS: In multivariate logistic regression, body composition components, the fat mass index (odds ratio [OR], 0.848; 95% confidence interval [CI], 0.786-0.913; P < 0.001) and the phase angle (PA; OR, 0.654; 95% CI, 0.467-0.826; P = 0.001), were independently and significantly negatively associated with RA after disease development. In multilinear regression analysis, PA was consistently associated with OP-RP, specifically concerning the spongial bone mineral density (BMDSPN) and cortical index, where ageing, reduced PA and increased disease duration explained 31.5% of BMDSPN and 37.3% of cortical index variation. CONCLUSION: Data on RA in women in Kazakhstan consistently show that fat mass index and PA act as independent major covariates associated with RA affection status. These findings suggest exacerbated body composition deterioration when compared with healthy controls, potentially indicating the early appearance of sarcopenia and likely cachexic-like properties. The data also suggest that PA could serve as a potential predictor of RA prognosis, and the concomitant development of osteoporosis.

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

PURPOSE: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.

Quantitative genetics of circulating Hyaluronic Acid (HA) and its correlation with hand osteoarthritis and obesity-related phenotypes in a community-based sample.

BACKGROUND: One of the potential molecular biomarkers of osteoarthritis (OA) is hyaluronic acid (HA). HA levels may be related to the severity and progression of OA. However, little is known about the contribution of major risk factors for osteoarthritis, e.g. obesity-related phenotypes and genetics to HA variation. AIM: To clarify the quantitative effect of these factors on HA. SUBJECTS AND METHODS: An ethnically homogeneous sample of 911 apparently healthy European-derived individuals, assessed for radiographic hand osteoarthritis (RHOA), HA, leptin, adiponectin, and several anthropometrical measures of obesity-related phenotypes was studied. Model-based quantitative genetic analysis was used to reveal genetic and shared environmental factors affecting the variation of the study's phenotypes. RESULTS: The HA levels significantly correlated with the age, RHOA, adiponectin, obesity-related phenotypes, and the waist-to-hip ratio. The putative genetic effects contributed significantly to the variation of HA (66.2 ± 9.3%) and they were also significant factors in the variations of all the other studied phenotypes, with the heritability estimate ranging between 0.122 ± 4.4% (WHR) and 45.7 ± 2.2% (joint space narrowing). CONCLUSIONS: This is the first study to report heritability estimates of HA variation and its correlation with obesity-related phenotypes, ADP and RHOA. However, the nature of genetic effects on HA and its correlation with other study phenotypes require further clarification.