ArticleFrontiers in medicine2026
Development and validation of a nomogram predicting osteoporosis risk in rheumatoid arthritis.
Article in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Rheumatoid arthritis (RA) increases the risk of osteoporosis, but tools that integrate RA-specific clinical and metabolic factors to predict osteoporosis risk are limited. We aimed to develop and validate a practical risk prediction nomogram for osteoporosis in RA patients. Methods: In this single-center retrospective study, 349 RA patients with available DXA data were analyzed; 132 (37.8%) had osteoporosis. A training cohort ( Results: Female sex, higher health assessment questionnaire-disability index (HAQ-DI), elevated alkaline phosphatase (ALP), increased ApoA1/ApoB ratio, higher free fatty acids (FFA), and lower body mass index (BMI) were independent predictors of osteoporosis and were included in the nomogram. The model yielded AUROCs of 0.812 (training) and 0.788 (validation), showed good calibration (Hosmer-Lemeshow Conclusion: The proposed nomogram, built from readily available clinical and laboratory measures, demonstrates good discrimination, calibration, and clinical utility for identifying RA patients at elevated risk of osteoporosis, and may facilitate targeted screening and early intervention. However, the model's performance in diverse populations remains unknown, and prospective multicenter external validation is essential before any clinical application.
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