PREVALENCE OF OSTEOPOROSIS IN PATIENTS WITH RHEUMATOID ARTHRITIS IN IRAQI KURDISTAN /DUHOK GOVERNORATE.

Background and objectives: The prevalence of osteoporosis among patients with rheumatoid arthritis (RA) in the Duhok governorate of Iraqi Kurdistan underscores a significant health concern that intersects autoimmune and bone health. The present study aimed to assess the prevalence of osteoporosis among patients with rheumatoid arthritis (RA) in the Duhok governorate.

Methods: Detailed questionnaire to collect demographic data, essential for identifying factors influencing BMD, such as age, sex, and lifestyle were used. Participants then underwent Dual-energy X-ray Absorptiometry (DXA) scans, a precise imaging technique for measuring BMD.

Results: The study involved middle-aged adults with an average age of 57.6 years, primarily females (91.5%), who had rheumatoid arthritis (RA) for about 15 years. Most participants were non-educated (71.5%) and lived in urban areas (77.1%). The majority worked in moderately heavy jobs (58.6%) and were married (98.5%). Most patients did not engage in exercise (84.3%), were non-smokers (77.1%), and alcohol-free (100%). Nearly half had a family history of RA, and all were tuberculosis-free. Clinically, most patients were obese, with 65.7% having comorbidities like hypertension and diabetes. A significant proportion tested positive for rheumatoid factors (74.3% for Rheumatoid factor and 84.3% for Anti-CCP) but were negative for DAS28-ESR. None had subcutaneous nodules, erosions, or joint surgeries. Regarding treatment, 65.7% used one DMARD, while 34.3% used two, and only 5.7% were on biologics; 80% also used corticosteroids. Osteoporosis was prevalent, with 80% showing signs (34.2% with osteopenia and 45.8% with osteoporosis).

Conclusion: Such efforts should focus on integrating routine bone health evaluations into RA care protocols, necessitating collaborative endeavors among rheumatologists, endocrinologists, and primary care professionals. This interdisciplinary model aims not only at early diagnosis but also at formulating comprehensive management plans tailored to the unique needs of this demographic within Iraqi Kurdistan's healthcare framework.