Clinical Rheumatology

, Volume 38, Issue 4, pp 1067–1074 | Cite as

A TRAF6 genetic variant is associated with low bone mineral density in rheumatoid arthritis

  • Hana Ben Hassine
  • Ramzi Zemni
  • Imen Ben Nacef
  • Asma Boumiza
  • Foued Slama
  • Khadija Baccouche
  • Najla Amri
  • Sarra Melayah
  • Zahid Shakoor
  • Adel Almogren
  • Elyes Bouajina
  • Rim SghiriEmail author
Original Article



This study was aimed to investigate the association of the single nucleotide polymorphism of tumor necrosis factor receptor associated factor 6 (TRAF6), rs540386, with low bone mineral density (BMD) among patients with rheumatoid arthritis (RA).


TRAF6 rs540386 genotyping was performed by mutagenically separated PCR in a cohort of 188 (23 men, 165 women, median age, 56.2 years) adult RA patients and 224 age and gender-matched controls. BMD was measured using dual-energy X-ray absorptiometry (DXA) (Lunar Prodigy advance scans, GE Healthcare, USA).


Among the RA patients, 64 (55 women, 9 men) had low BMD comprising of 57 patients with osteoporosis and 7 with osteopenia. Whereas TRAF6 rs540386 was not associated with RA susceptibility, it was however found to be a risk factor for reduced lumbar spine Z-score in the recessive model (OR = 3.34, 95% CI = (1.01–11.00), p = 0.038). This association was confirmed further in the multivariate logistic regression analysis taking into account several potential confounding factors (OR = 3.34 (1.01–11.00), p = 0.048). In addition, mean total femur Z-score was found to be reduced in TT patients when compared to CC + CT patients (− 1.30 ± 1.32 versus − 0.60 ± 1.05, p = 0.034). No association between TRAF6 rs540386 and local bone damage was observed.


This study for the first time ever demonstrated an association between a genetic variant of TRAF6 and low BMD among patients with RA. Further investigations are needed to elucidate the exact role of this variant.


Bone mineral density Mutagenically separated polymerase chain reaction (MS-PCR) Osteoporosis Rheumatoid arthritis rs540386 Tumor necrosis factor receptor associated factor 6 (TRAF6) 



This study was supported by the college of Medicine Research center, Deanship of Scientific Research, King Saud University, Riyadh, Saudi Arabia.

Compliance with ethical standards




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Copyright information

© International League of Associations for Rheumatology (ILAR) 2018

Authors and Affiliations

  • Hana Ben Hassine
    • 1
  • Ramzi Zemni
    • 1
  • Imen Ben Nacef
    • 1
  • Asma Boumiza
    • 1
  • Foued Slama
    • 1
  • Khadija Baccouche
    • 2
  • Najla Amri
    • 2
  • Sarra Melayah
    • 1
  • Zahid Shakoor
    • 3
  • Adel Almogren
    • 3
  • Elyes Bouajina
    • 2
  • Rim Sghiri
    • 1
    • 3
    Email author
  1. 1.Laboratory of Immunology, Research Unit UR 807, Faculty of Medicine of SousseSousseTunisia
  2. 2.Department of RheumatologyFarhat Hached HospitalSousseTunisia
  3. 3.Department of Pathology, College of MedicineKing Saud UniversityRiyadhSaudi Arabia

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