Elevated serum levels of soluble receptor activator of nuclear factors-κB ligand (sRANKL) and reduced bone mineral density in patients with ankylosing spondylitis (AS)
Elevated serum levels of soluble receptor activator of nuclear factors-κB ligand (sRANKL) and reduced bone mineral density in patients with ankylosing spondylitis (AS)
复制标题
DOI：
10.1093/rheumatology/kel072
复制
发表时间：
2006-10-01
期刊：
影响因子：
5.5
通讯作者：
Lee, S. -H.
中科院分区：
文献类型：
--
作者：
Kim, H. -R.;Kim, H. -Y.;Lee, S. -H.
目标。目的评估强直性脊柱炎（AS）患者骨密度（BMD）、血清可溶性核因子受体激活物- κ B配体（sRANKL）和骨保护素（OPG）水平，并探讨其与疾病活动度的关系。采用夹心酶联免疫吸附法测定AS患者血清中sRANKL和OPG水平。采用盆式强直性脊柱炎疾病活动评分指数、盆式强直性脊柱炎功能指数、盆式强直性脊柱炎计量指数和盆式强直性脊柱炎患者整体评分确定疾病活动度。采用双能x线骨密度仪测定股骨、腰椎骨密度。放射学分级由骶髂炎和斯托克强直性脊柱炎脊柱评分的纽约标准确定。股骨颈骨质疏松和骨质减少分别占33%和41%。股骨颈骨密度与疾病活动性指标、红细胞沉降率、c反应蛋白呈负相关。AS患者血清sRANKL水平和sRANKL / OPG比值明显高于对照组。骨密度降低和影像学表现为活动性炎症的患者，其sRANKL/OPG比值有增加的趋势。约74%的AS患者骨密度降低，这一变化反映了疾病的活动性。AS患者血清sRANKL水平和sRANKL/OPG比值上调，并与骨密度和影像学变化有关。这些结果提示，RANKL和OPG之间的失衡可能参与了AS骨质疏松症的发病机制和临床病程。
Objective. To assess bone mineral density (BMD), serum levels of soluble receptor activator of nuclear factors-kappa B ligand (sRANKL) and osteoprotegerin (OPG) in patients with ankylosing spondylitis (AS), and to determine their relationships with disease activities.Methods. Serum levels of sRANKL and OPG in AS were measured by sandwich enzyme-linked immunosorbent assay. The disease activities were determined using Bath Ankylosing Spondylitis Disease Activity Score Index, Bath Ankylosing Spondylitis Functional Index, Bath Ankylosing Spondylitis Metrology Index and Bath Ankylosing Spondylitis Patient Global Score. BMD of femur and lumbar spine was measured by dual energy X-ray absorptiometry. Radiological grading was determined by New York criteria for sacroiliitis and modified Stoke Ankylosing Spondylitis Spine Score.Results. Osteoporosis and osteopaenia of femoral neck were found in 33 and 41% of patients, respectively. BMD of femoral neck showed negative correlation with disease activity indexes, erythrocyte sedimentation rate and C-reactive protein. The serum sRANKL levels and the ratio of sRANKL to OPG were significantly higher in patients with AS than those of controls. The sRANKL/OPG ratio tended to increase in patients with reduced BMD and radiological findings of active inflammation.Conclusion. About 74% of AS patients have reduced BMD and this change reflects disease activity. Serum sRANKL levels and sRANKL/OPG ratios are up-regulated in patients with AS and have relationship with BMD and radiological changes. These results suggest that the imbalance between RANKL and OPG might be involved in the pathogenesis and clinical courses of osteoporosis in AS.