The relationship between osteoarthritis of the hands, bone mineral density, and bone turnover markers

Aim: To investigate the relationship between hand osteoarthritis (HOA), bone mineral density (BMD), and bone turnover markers. Methods: Twenty post-menopausal women aged 50-73 years (mean: 62.4 +/- 6.5) diagnosed with HOA were recruited along with 10 age-matched post-menopausal women with no signs of HOA as the control group. Both groups had postero-anterior hand radiographs taken and evaluated according to the Kellgren-Lawrence scale to assess OA severity. They underwent thorough clinical examination including measurement of body mass index (BMI). They completed the AUSCAN questionnaire. Grip strength was measured using a hand held dynamometer and lateral pinch strength was measured using a pinchmeter. They underwent BMD measurement at the hip and wrist using Dual energy X-ray absorptiometry. Furthermore, they had serum osteocalcin and urinary deoxypyridinoline (DPD) measured. Results: There was no statistically significant difference in T-scores of the hip (P = 0.168) and wrist (P = 0.45) between the patients and the controls. However, six patients (30%) had osteoporosis. A total of 12 patients had diminished BMD at the hip. There was no significant increase in serum osteocalcin levels in patients compared to controls (P = 0.382). However, urinary DPD was significantly elevated in the patient group compared to the controls, (P < 0.0001). There was a positive correlation between T-scores at the hip and BMI (P = 0.017). There was a negative correlation of T-scores at the hip and wrist with postmenopausal duration and parity. There was no correlation between the T-scores and bone turnover markers. There was a positive correlation between OA severity and both T and Z-scores at the wrist. Conclusions: Although there was no significant association between HOA and BMD, HOA is associated with increased bone turnover as demonstrated by the significant elevation in urinary DPD. These patients should be followed up to assess the need for medical treatment to prevent future fractures. (C) 2011 Alexandria University Faculty of Medicine. Production and hosting by Elsevier B.V. All rights reserved.