{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:15:31Z","timestamp":1787019331040,"version":"build-2736575974"},"reference-count":57,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100012166","name":"the National Key R&D Program of China","doi-asserted-by":"publisher","award":["2022YFC3600600"],"award-info":[{"award-number":["2022YFC3600600"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]},{"name":"the Experimental Discipline Revitalization Plan of West China School of Public Health and West China Fourth Hospital","award":["2023SY-03"],"award-info":[{"award-number":["2023SY-03"]}]},{"name":"Projects from West China School of Public Health and West China Fourth Hospital, Sichuan University"},{"DOI":"10.13039\/501100018549","name":"recruitment program for young professionals","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100018549","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"the National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["U22A20359, 81874283, 81673255"],"award-info":[{"award-number":["U22A20359, 81874283, 81673255"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"the Promotion Plan for Basic Medical Sciences and the Development Plan for Cutting-Edge Disciplines, Sichuan University"},{"name":"the Science Fund for Creative Research Groups of Science and Technology Bureau of Sichuan Province","award":["2024NSFTD0030"],"award-info":[{"award-number":["2024NSFTD0030"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Therapeutic Advances in Musculoskeletal"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The co-occurrence of osteoporosis (OP) and rheumatoid arthritis (RA) has long been observed; their intrinsic link, however, has not been fully understood.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>We aimed to inform the importance of integrated care targeting both diseases by investigating the phenotypic as well as the genetic relationships underlying OP and RA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>This is a prospective cohort study and genome-wide cross-trait analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      We evaluated phenotypic associations using longitudinal follow-up data from the UK Biobank (\n                      <jats:italic toggle=\"yes\">N<\/jats:italic>\n                      \u2009=\u2009472,050). We investigated genetic relationships by leveraging summary statistics from the largest genome-wide association study in European ancestry conducted for RA (\n                      <jats:italic toggle=\"yes\">N<\/jats:italic>\n                      <jats:sub>case\/control<\/jats:sub>\n                      \u2009=\u200922,350\/74,823), seropositive RA (\n                      <jats:italic toggle=\"yes\">N<\/jats:italic>\n                      <jats:sub>case\/control<\/jats:sub>\n                      \u2009=\u200917,221\/74,823), and a reliable proxy of OP\u2014the heel estimated bone mineral density (eBMD;\n                      <jats:italic toggle=\"yes\">N<\/jats:italic>\n                      \u2009=\u2009426,824).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Observational analysis suggested a bidirectional relationship (OP\u2009\u2192\u2009RA: hazard ratio (HR)\u2009=\u20091.59, 95% confidence interval (CI)\u2009=\u20091.28\u20131.97; RA\u2009\u2192\u2009OP: HR\u2009=\u20092.94, 95% CI\u2009=\u20092.59\u20133.35). A negative overall genetic correlation was observed for eBMD with RA (\u2009=\u2009\u22120.06,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20091.37\u2009\u00d7\u200910\n                      <jats:sup>\u22125<\/jats:sup>\n                      ) and with its seropositive subtype (\n                      <jats:italic toggle=\"yes\">r<\/jats:italic>\n                      <jats:sub>g<\/jats:sub>\n                      \u2009=\u2009\u22120.06,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20099.15\u2009\u00d7\u200910\n                      <jats:sup>\u22126<\/jats:sup>\n                      ). Cross-trait meta-analysis replicated 96 previously reported trait-associated loci and discovered three novel pleiotropic loci (rs72836346, rs2613812, and rs76458888). Transcriptome-wide association study revealed 23 shared genes. Mendelian randomization analysis suggested a putative causal effect of eBMD on RA (odds ratio (OR)\u2009=\u20090.90, 95% CI\u2009=\u20090.84\u20130.96), but not of RA on eBMD.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Our work demonstrates a significant biological pleiotropy as well as a putative causal relationship between OP and RA, emphasizing an intrinsic link underlying the pronounced phenotypic association. These findings highlight the possibility of preventing and predicting RA development by monitoring and interfering with bone loss in preclinical high-risk individuals.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1759720x251412846","type":"journal-article","created":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T13:16:19Z","timestamp":1770902179000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Investigating the relationship between osteoporosis and rheumatoid arthritis: prospective cohort study and genetic analyses"],"prefix":"10.1177","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-6010-6114","authenticated-orcid":false,"given":"Lingli","family":"Qiu","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Biostatistics, Institute of Systems Epidemiology, and West China-PUMC C. C. 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