Association Between Bone Mineral Density and Autoantibodies in Patients With Rheumatoid Arthritis

被引:20
|
作者
Amkreutz, Josephine A. M. P. [1 ]
de Moel, Emma C. [1 ]
Theander, Lisa [2 ]
Willim, Minna [2 ,3 ,4 ]
Heimans, Lotte [1 ]
Nilsson, Jan-Ake [2 ,3 ,4 ,5 ]
Karlsson, Magnus K. [2 ,3 ]
Huizinga, Tom W. J. [1 ]
Akesson, Kristina E. [2 ,3 ]
Jacobsson, Lennart T. H. [2 ,6 ]
Allaart, Cornelia F. [1 ]
Turesson, Carl [2 ,3 ,4 ,5 ]
van der Woude, Diane [1 ]
机构
[1] Leiden Univ, Med Ctr, POB 9600, NL-2300 RC Leiden, Netherlands
[2] Lund Univ, Malmo, Sweden
[3] Skane Univ Hosp, Malmo, Sweden
[4] Skane Univ Hosp, Lund, Sweden
[5] Lund Univ, Lund, Sweden
[6] Gothenburg Univ, Gothenburg, Sweden
关键词
CITRULLINATED PROTEIN ANTIBODIES; DISEASE-ACTIVITY; MECHANISMS; DIAGNOSIS; EROSION; OSTEOPOROSIS; ONSET; ACPA;
D O I
10.1002/art.41623
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective Autoantibodies, such as anti-citrullinated protein antibodies (ACPAs), have been described as inducing bone loss in rheumatoid arthritis (RA), which can also be reflected by bone mineral density (BMD). We therefore examined the association between osteoporosis and autoantibodies in two independent RA cohorts. Methods Dual x-ray absorptiometry (DXA) of the lumbar spine and left hip was performed in 408 Dutch patients with early RA during 5 years of follow-up and in 198 Swedish patients with early RA during 10 years of follow-up. The longitudinal effect of ACPAs and other autoantibodies on several BMD measures was assessed using generalized estimating equations. Results In the Dutch cohort, significantly lower BMD at baseline was observed in ACPA-positive patients compared to ACPA-negative patients, with an estimated marginal mean BMD in the left hip of 0.92 g/cm(2) (95% confidence interval [95% CI] 0.91-0.93) versus 0.95 g/cm(2) (95% CI 0.93-0.97) (P = 0.01). In line with this, significantly lower Z scores at baseline were noted in the ACPA-positive group compared to the ACPA-negative group (estimated marginal mean Z score in the left hip of 0.18 [95% CI 0.08-0.29] versus 0.48 [95% CI 0.33-0.63]) (P < 0.01). However, despite clear differences at baseline, ACPA positivity was not associated with greater decrease in absolute BMD or Z scores over time. Furthermore, there was no association between BMD and higher levels of ACPAs or other autoantibodies (rheumatoid factor and anti-carbamylated protein antibodies). In the Swedish cohort, ACPA-positive patients tended to have a higher prevalence of osteopenia at baseline (P = 0.04), but again, ACPA positivity was not associated with an increased prevalence of osteopenia or osteoporosis over time. Conclusion The presence of ACPAs is associated with significantly lower BMD at baseline, but not with greater BMD loss over time in treated RA patients. These results suggest that ACPAs alone do not appear to contribute to bone loss after disease onset when disease activity is well-managed.
引用
收藏
页码:921 / 930
页数:10
相关论文
共 50 条
  • [21] Peripheral bone density in patients with rheumatoid arthritis
    Franck, Helmut
    Gottwalt, Jurgen
    CLINICAL RHEUMATOLOGY, 2009, 28 (10) : 1141 - 1145
  • [22] Risk Factors for Systemic Reduced Bone Mineral Density in Premenopausal Female Patients with Early Untreated Rheumatoid Arthritis
    Ahmed, Hamada S.
    Farrag, Sherif E.
    Okasha, Amr E.
    Othman, Gamal
    Shady, Ibrahim
    AKTUELLE RHEUMATOLOGIE, 2020, 45 (04) : 334 - 340
  • [23] Relation between bone mineral density and IL-17 serum levels in Serbian patients with early Rheumatoid arthritis
    Pavlovic, Voja
    Dimic, Aleksandar
    Milenkovic, Sasa
    Krtinic, Dane
    Aleksic, Ivana
    OPEN MEDICINE, 2015, 10 (01): : 106 - 112
  • [24] Relationship between bone mineral density and urine level of NTx in rheumatoid arthritis
    Nonaka, T
    Nishisaka, F
    Fukuda, K
    Sohen, S
    Hamanishi, C
    JOURNAL OF BONE AND MINERAL METABOLISM, 2005, 23 (04) : 314 - 317
  • [25] Relationship between bone mineral density and urine level of NTx in rheumatoid arthritis
    Tohgo Nonaka
    Fumiaki Nishisaka
    Kanji Fukuda
    Satoshi Sohen
    Chiaki Hamanishi
    Journal of Bone and Mineral Metabolism, 2005, 23 : 314 - 317
  • [26] Changes in hand bone mineral density and the association with the level of disease activity in patients with rheumatoid arthritis: Bone mineral density measurements in a multicenter randomized clinical trial
    Dirven, L.
    Guler-Yuksel, M.
    de Beus, W. M.
    Ronday, H. K.
    Speyer, I.
    Huizinga, T. W. J.
    Dijkmans, B. A. C.
    Allaart, C. F.
    Lems, W. F.
    ARTHRITIS CARE & RESEARCH, 2011, 63 (12) : 1691 - 1699
  • [27] Bone mineral density in Indian women with rheumatoid arthritis
    Shankar, Subramanian
    Handa, Rohini
    Aneja, Ritu
    Marwaha, Vishal
    Ammini, A. C.
    Aprajita, V.
    RHEUMATOLOGY INTERNATIONAL, 2009, 29 (04) : 377 - 381
  • [28] Circulating Leptin and Bone Mineral Density in Rheumatoid Arthritis
    Aguilar-Chavez, Erika A.
    Gamez-Nava, Jorge I.
    Lopez-Olivo, Maria A.
    Galvan-Melendres, Silvia
    Corona-Sanchez, Esther G.
    Loaiza-Cardenas, Carlos A.
    Celis, Alfredo
    Cardona-Munoz, Ernesto G.
    Gonzalez-Lopez, Laura
    JOURNAL OF RHEUMATOLOGY, 2009, 36 (03) : 512 - 516
  • [29] Bone mineral density in Indian women with rheumatoid arthritis
    Subramanian Shankar
    Rohini Handa
    Ritu Aneja
    Vishal Marwaha
    A. C. Ammini
    V. Aprajita
    Rheumatology International, 2009, 29
  • [30] Sex and age do not modify the association between glucocorticoids and bone mineral density in patients with rheumatoid arthritis: a cross-sectional study
    Palmowski, Andriko
    Boyadzhieva, Zhivana
    Nielsen, Sabrina M.
    Muche, Burkhard
    Hermann, Sandra
    Boers, Maarten
    Bliddal, Henning
    Christensen, Robin
    Wiebe, Edgar
    Buttgereit, Frank
    ARTHRITIS RESEARCH & THERAPY, 2023, 25 (01)