Catabolic and anabolic periarticular bone changes in patients with rheumatoid arthritis: a computed tomography study on the role of age, disease duration and bone markers.
Catabolic and anabolic periarticular bone changes in patients with rheumatoid arthritis: a computed tomography study on the role of age, disease duration and bone markers.
复制标题
DOI：
10.1186/ar4235
复制
发表时间：
2013
影响因子：
4.9
通讯作者：
Schett G
中科院分区：
文献类型：
--
作者：
Aschenberg S;Finzel S;Schmidt S;Kraus S;Engelke K;Englbrecht M;Rech J;Schett G
本研究的目的是确定决定类风湿关节炎（RA）患者分解代谢和合成代谢关节周围骨变化的因素，包括骨吸收和骨形成标志物。 40 名 RA 患者在两个连续时间点（基线，一年随访）接受了主要受影响手的掌指关节 II 和 III 的高分辨率外周定量计算机断层扫描 (HR-pQCT) 分析。记录侵蚀计数和评分以及骨赘计数和评分。同时，评估骨吸收的血清标志物（I型胶原的C端端肽（CTX I）、抗酒石酸酸性磷酸酶5b（TRAP5b））、骨形成（骨碱性磷酸酶（BAP）、骨钙素（OC））和钙稳态（甲状旁腺激素（PTH）、25-羟基维生素D3（Vit D））。通过对各种人口统计和疾病特异性参数进行部分相关调整，将骨生物标志物与成像数据相关联。此外，通过混合线性模型回归分析成像数据。偏相关分析显示，在两个时间点，TRAP5b 水平与骨侵蚀显着相关，而 BAP 水平与骨赘相关。在以侵蚀为因变量的混合线性模型中，疾病持续时间（P <0.001）是这些骨分解代谢变化的关键决定因素。相比之下，BAP (P = 0.001) 以及年龄 (P = 0.018)，而不是病程 (P = 0.762)，是 RA 患者关节周围骨合成代谢变化（骨赘）的主要决定因素。这项研究表明，用 HR-pQCT 评估的骨结构变化伴随着骨吸收和骨形成的全身标志物的变化。此外，可以表明RA患者的骨侵蚀取决于病程，而骨赘则与年龄以及血清BAP水平相关。因此，这些数据不仅表明不同的变量参与 RA 患者骨侵蚀和骨赘的形成，而且表明关节周围骨的变化与骨代谢全身标志物的变化相关，指出 BAP 是一个重要参数。
The 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). Forty 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. Partial 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. This 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.
登录
查看更多内容
影响因子：
6.2
作者：
Walsh, Nicole C.;Reinwald, Susan;Gravallese, Ellen M.
通讯作者：
Gravallese, Ellen M.
影响因子：
27.4
作者：
Lems, WF;Gerrits, MI;Bijlsma, JWJ
通讯作者：
Bijlsma, JWJ
影响因子：
27.4
作者：
Syversen, Silje W.;Haavardsholm, Espen A.;Kvien, Tore K.
通讯作者：
Kvien, Tore K.
影响因子：
27.4
作者：
Landewé, RBM;Geusens, P;Garnero, P
通讯作者：
Garnero, P
影响因子：
--
作者：
Garnero, Patrick;Thompson, Elizabeth;Smolen, Josef S.
通讯作者：
Smolen, Josef S.