Catabolic and anabolic periarticular bone changes in patients with rheumatoid arthritis: a computed tomography study on the role of age, disease duration and bone markersReportar como inadecuado




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Arthritis Research and Therapy

, 15:R62

First Online: 27 May 2013Received: 18 January 2013Revised: 16 March 2013Accepted: 27 May 2013

Abstract

IntroductionThe aim of this study was to determine the factors, including markers of bone resorption and bone formation, which determine catabolic and anabolic periarticular bone changes in patients with rheumatoid arthritis RA.

MethodsForty RA patients received high-resolution peripheral quantitative computed tomography HR-pQCT analysis of the metacarpophalangeal joints II and III of the dominantly affected hand at two sequential time points baseline, one year follow-up. Erosion counts and scores as well as osteophyte counts and scores were recorded. Simultaneously, serum markers of bone resorption C-terminal telopeptide of type I collagen CTX I, tartrate-resistant acid phosphatase 5b TRAP5b, bone formation bone alkaline phosphatase BAP, osteocalcin OC and calcium homeostasis parathyroid hormone PTH, 25-hydroxyvitamin D3 Vit D were assessed. Bone biomarkers were correlated to imaging data by partial correlation adjusting for various demographic and disease-specific parameters. Additionally, imaging data were analyzed by mixed linear model regression.

ResultsPartial correlation analysis showed that TRAP5b levels correlate significantly with bone erosions, whereas BAP levels correlate with osteophytes at both time points. In the mixed linear model with erosions as the dependent variable, disease duration P <0.001 was the key determinant for these catabolic bone changes. In contrast, BAP P = 0.001 as well as age P = 0.018, but not disease duration P = 0.762, were the main determinants for the anabolic changes osteophytes of the periarticular bone in patients with RA.

ConclusionsThis study shows that structural bone changes assessed with HR-pQCT are accompanied by alterations in systemic markers of bone resorption and bone formation. Besides, it can be shown that bone erosions in RA patients depend on disease duration, whereas osteophytes are associated with age as well as serum level of BAP. Therefore, these data not only suggest that different variables are involved in formation of bone erosions and osteophytes in RA patients, but also that periarticular bone changes correlate with alterations in systemic markers of bone metabolism, pointing out BAP as an important parameter.

KeywordsRheumatoid arthritis bone resorption bone formation computed tomography bone biomarkers AbbreviationsACRAmerican College of Rheumatology

BAPbone alkaline phosphatase

CRPC-reactive protein

CTX-IC-terminal telopeptide of type I collagen

DASDisease Activity Score

DMARDsdisease-modifying antirheumatic drugs

ESRerythrocyte sedimentation rate

HR-pQCThigh-resolution peripheral quantitative computed tomography

ICCintraclass correlation coefficient

MCPmetacarpophalangeal

MTXmethotrexate

OCosteocalcin

PTHparathyroid hormone

RArheumatoid arthritis

TRAP5btartrate-resistant acid phosphatase 5b

TNFtumor necrosis factor

Vit D25-hydroxyvitamin D3.

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Autor: Sophie Aschenberg - Stephanie Finzel - Sarah Schmidt - Sebastian Kraus - Klaus Engelke - Matthias Englbrecht - Jürgen Rech

Fuente: https://link.springer.com/







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