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The study of bone mineral density and bone turnover markers in postmenopausal women with active rheumatoid arthritis

  • ORIGINAL ARTICLE
  • Published:
Modern Rheumatology

Abstract

The aim of this study was to investigate determinants of reduced bone mineral density (BMD) in postmenopausal women with active rheumatoid arthritis (RA) and to evaluate whether there are common markers of bone loss. We evaluated BMD of the femoral neck using dual-energy X-ray absorptiometry, and the measured biochemical markers included serum bone-specific alkaline phosphatase (BALP), serum osteocalcin (OC), and serum cross-linked N-telopeptidases of type I collagen (NTx). Serum BALP and NTx concentrations were measured by enzyme-linked immunsorbent assay, and OC was measured using an immunoradiometric assay. One hundred and forty postmenopausal Japanese women who had not received treatment with bisphosphonates or hormone replacement therapy were entered into the study. Thirty-four patients (41.0%) had femoral osteopenia (T score −1 to −2.5) and 23 patients (27.7%) had osteoporosis (T < −2.5). The body mass index of patients with normal BMD (T score ≥ −1.0) was significantly higher (P < 0.01) than in patients with osteoporosis at the femoral neck. The T score exhibited a significant negative correlation with age and the duration of RA disease. Serum BALP and serum OC, markers of osteoblast function, were negatively related to erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and matrix metalloproteinase-3 (MMP-3). However, serum NTx, a marker of resorptive function, exhibited a positive correlation with ESR, CRP, and MMP-3. From these results, this study suggests that generalized bone loss occurs in active RA and is characterized by evidence of bone resorption that is correlated with the high levels of inflammation. Body mass index, disease duration, and high serum NTx level were common risk factors in osteoporosis of postmenopausal women with RA.

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References

  1. A Deodhar A Woolf (1996) ArticleTitleBone mass measurement and bone metabolism in rheumatoid arthritis Br J Rheumatol 35 309–22 Occurrence Handle8624634 Occurrence Handle1:STN:280:DyaK283hs12itA%3D%3D Occurrence Handle10.1093/rheumatology/35.4.309

    Article  PubMed  CAS  Google Scholar 

  2. A Verstraeten J Dequeker (1986) ArticleTitleVertebral and peripheral bone mineral content and fracture incidence in postmenopausal patients with rheumatoid arthritis: effect of low dose corticosteroids Ann Rheum Dis 45 852–7 Occurrence Handle3789820 Occurrence Handle1:STN:280:DyaL2s%2FnsFSksg%3D%3D Occurrence Handle10.1136/ard.45.10.852

    Article  PubMed  CAS  Google Scholar 

  3. TM Huusko M Korpela P Karppi V Avikainen H Kautiainen R Sulkava (2001) ArticleTitleThreefold increased risk of hip fractures with rheumatoid arthritis in Central Finland Ann Rheum Dis 60 521–2 Occurrence Handle10.1136/ard.60.5.521 Occurrence Handle11302878 Occurrence Handle1:STN:280:DC%2BD3M3oslyisg%3D%3D

    Article  PubMed  CAS  Google Scholar 

  4. R Westhovens J Dequeker (2000) ArticleTitleRheumatoid arthritis and osteoporosis Z Rheumatol 59 33–8 Occurrence Handle10.1007/s003930070036 Occurrence Handle10769433

    Article  PubMed  Google Scholar 

  5. A Gough P Sambrook J Devlin A Huissoon C Njeh S Robbins et al. (1998) ArticleTitleOsteoclastic activation is the principal mechanism leading to secondary osteoporosis in rheumatoid arthritis J Rheumatol 25 1282–9 Occurrence Handle9676757 Occurrence Handle1:STN:280:DyaK1czjvFekuw%3D%3D

    PubMed  CAS  Google Scholar 

  6. KG Saag (2003) ArticleTitleGlucocorticoid-induced osteoporosis Endocrinol Metab Clin North Am 32 135–57 Occurrence Handle10.1016/S0889-8529(02)00064-6 Occurrence Handle12699296 Occurrence Handle1:CAS:528:DC%2BD3sXjtFOjsbo%3D

    Article  PubMed  CAS  Google Scholar 

  7. G Haugeberg RE Orstavik TK Kvien (2003) ArticleTitleEffects of rheumatoid arthritis on bone Curr Opin Rheumatol 15 469–75 Occurrence Handle10.1097/00002281-200307000-00016 Occurrence Handle12819477

    Article  PubMed  Google Scholar 

  8. Y Furumitsu M Inaba K Yukioka M Yukioka Y Kumeda Y Azuma et al. (2000) ArticleTitleLevels of serum and synovial fluid pyridinium cross-links in patients with rheumatoid arthritis J Rheumatol 27 64–70 Occurrence Handle10648019 Occurrence Handle1:STN:280:DC%2BD3c7ht1Gntw%3D%3D

    PubMed  CAS  Google Scholar 

  9. FC Arnett SM Edworthy DA Bloch DJ McShane JF Fries NS Cooper et al. (1988) ArticleTitleThe American Rheumatism Association 1987 revised criteria for classification of rheumatoid arthritis Arthritis Rheum 31 315–24 Occurrence Handle3358796 Occurrence Handle1:STN:280:DyaL1c7pt1Ohsg%3D%3D Occurrence Handle10.1002/art.1780310302

    Article  PubMed  CAS  Google Scholar 

  10. JA Kanis LJ Melton Suffix3rd C Christiansen CC Johnston N Khaltaev (1994) ArticleTitleThe diagnosis of osteoporosis J Bone Miner Res 9 1137–41 Occurrence Handle7976495 Occurrence Handle1:STN:280:DyaK2M%2FmslSisA%3D%3D Occurrence Handle10.1002/jbmr.5650090802

    Article  PubMed  CAS  Google Scholar 

  11. PD Miller SL Bonnick CJ Rosen RD Altman LV Avioli J Dequeker et al. (1996) ArticleTitleClinical utility of bone mass measurements in adults: consensus of an international panel. The Society for Clinical Densitometry Semin Arthritis Rheum 25 361–72 Occurrence Handle10.1016/S0049-0172(96)80001-1 Occurrence Handle8792508 Occurrence Handle1:STN:280:DyaK28zosVKhsg%3D%3D

    Article  PubMed  CAS  Google Scholar 

  12. L Sinigaglia A Nervetti Q Mela G Bianchi A Del Puente O Di Munno et al. (2000) ArticleTitleA multicenter cross sectional study on bone mineral density in rheumatoid arthritis. Italian Study Group on Bone Mass in Rheumatoid Arthritis J Rheumatol 27 2582–9 Occurrence Handle11093437 Occurrence Handle1:STN:280:DC%2BD3M7otVOksg%3D%3D

    PubMed  CAS  Google Scholar 

  13. H Kroger M Tuppurainen R Honkanen E Alhava S Saarikoski (1994) ArticleTitleBone mineral density and risk factors for osteoporosis – a population-based study of 1600 perimenopausal women Calcif Tissue Int 55 1–7 Occurrence Handle7922782 Occurrence Handle1:STN:280:DyaK2M%2FgslWnsg%3D%3D Occurrence Handle10.1007/BF00310160

    Article  PubMed  CAS  Google Scholar 

  14. K Landin-Wilhelmsen L Wilhelmsen BA Bengtsson (1999) ArticleTitlePostmenopausal osteoporosis is more related to hormonal aberrations than to lifestyle factors Clin Endocrinol (Oxf) 51 387–94 Occurrence Handle1:STN:280:DC%2BD3c%2FltVCluw%3D%3D Occurrence Handle10.1046/j.1365-2265.1999.00776.x

    Article  CAS  Google Scholar 

  15. G Haugeberg T Uhlig JA Falch JI Halse TK Kvien (2000) ArticleTitleBone mineral density and frequency of osteoporosis in female patients with rheumatoid arthritis: results from 394 patients in the Oslo County Rheumatoid Arthritis register Arthritis Rheum 43 522–30 Occurrence Handle10728744 Occurrence Handle1:STN:280:DC%2BD3c7ptFSrug%3D%3D Occurrence Handle10.1002/1529-0131(200003)43:3<522::AID-ANR7>3.0.CO;2-Y

    Article  PubMed  CAS  Google Scholar 

  16. BA Michel DA Bloch F Wolfe JF Fries (1993) ArticleTitleFractures in rheumatoid arthritis: an evaluation of associated risk factors J Rheumatol 20 1666–9 Occurrence Handle8295176 Occurrence Handle1:STN:280:DyaK2c7isFersg%3D%3D

    PubMed  CAS  Google Scholar 

  17. H Forsblad D'Elia A Larsen E Waltbrand G Kvist D Mellstrom T Saxne et al. (2003) ArticleTitleRadiographic joint destruction in postmenopausal rheumatoid arthritis is strongly associated with generalized osteoporosis Ann Rheum Dis 62 617–23 Occurrence Handle10.1136/ard.62.7.617 Occurrence Handle12810422

    Article  PubMed  Google Scholar 

  18. RE Orstavik G Haugeberg T Uhlig JA Falch JI Halse et al. (2003) ArticleTitleVertebral deformities in 229 female patients with rheumatoid arthritis: associations with clinical variables and bone mineral density Arthritis Rheum 49 355–60 Occurrence Handle12794791 Occurrence Handle000183415500012 Occurrence Handle10.1002/art.11118

    Article  PubMed  ISI  Google Scholar 

  19. B Seriolo V Ferretti A Sulli E Caratto D Fasciolo M Cutolo (2002) ArticleTitleSerum osteocalcin levels in premenopausal rheumatoid arthritis patients Ann N Y Acad Sci 966 502–7 Occurrence Handle12114311 Occurrence Handle1:CAS:528:DC%2BD38XlvVWlsL4%3D

    PubMed  CAS  Google Scholar 

  20. B Cortet RM Flipo P Pigny B Duquesnoy A Boersma X Marchandise et al. (1998) ArticleTitleIs bone turnover a determinant of bone mass in rheumatoid arthritis? J Rheumatol 25 2339–44 Occurrence Handle9858427 Occurrence Handle1:STN:280:DyaK1M%2FnsVWgug%3D%3D

    PubMed  CAS  Google Scholar 

  21. AK Gough NF Peel R Eastell RL Holder J Lilley P Emery (1994) ArticleTitleExcretion of pyridinium cross-links correlates with disease activity and appendicular bone loss in early rheumatoid arthritis Ann Rheum Dis 53 14–7 Occurrence Handle8311548 Occurrence Handle1:STN:280:DyaK2c7ksFWkuw%3D%3D Occurrence Handle10.1136/ard.53.1.14

    Article  PubMed  CAS  Google Scholar 

  22. H Valleala L Laasonen MK Koivula J Mandelin C Friman J Risteli et al. (2003) ArticleTitleTwo year randomized controlled trial of etidronate in rheumatoid arthritis: changes in serum aminoterminal telopeptides correlate with radiographic progression of disease J Rheumatol 30 468–73 Occurrence Handle12610803 Occurrence Handle1:CAS:528:DC%2BD3sXisVKgsrw%3D

    PubMed  CAS  Google Scholar 

  23. TR Dykman OS Gluck WA Murphy TJ Hahn BH Hahn (1985) ArticleTitleEvaluation of factors associated with glucocorticoid-induced osteopenia in patients with rheumatic diseases Arthritis Rheum 28 361–8 Occurrence Handle3872664 Occurrence Handle1:STN:280:DyaL2M7nsVGmsw%3D%3D Occurrence Handle10.1002/art.1780280402

    Article  PubMed  CAS  Google Scholar 

  24. RF Laan PL van Riel LJ van Erning JA Lemmens SH Ruijs LB van de Putte (1992) ArticleTitleVertebral osteoporosis in rheumatoid arthritis patients: effect of low dose prednisone therapy Br J Rheumatol 31 91–6 Occurrence Handle1737238 Occurrence Handle1:STN:280:DyaK387ksFeisg%3D%3D Occurrence Handle10.1093/rheumatology/31.2.91

    Article  PubMed  CAS  Google Scholar 

  25. RF Laan PL van Riel LB van de Putte LJ van Erning MA van 't Hof JA Lemmens (1993) ArticleTitleLow-dose prednisone induces rapid reversible axial bone loss in patients with rheumatoid arthritis. A randomized, controlled study Ann Intern Med 119 963–8 Occurrence Handle8105737 Occurrence Handle1:STN:280:DyaK2c%2FivVertg%3D%3D

    PubMed  CAS  Google Scholar 

  26. PN Sambrook ML Cohen JA Eisman NA Pocock GD Champion MG Yeates (1989) ArticleTitleEffects of low dose corticosteroids on bone mass in rheumatoid arthritis: a longitudinal study Ann Rheum Dis 48 535–8 Occurrence Handle2774695 Occurrence Handle1:STN:280:DyaL1MzntlWmtA%3D%3D Occurrence Handle10.1136/ard.48.7.535

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Institute of Rheumatology, Tokyo Women's Medical University, 10-22 Kawada-cho, Shinjuku-ku, Tokyo, 162-0054, Japan

    Shigeki Momohara, Tamao Mizumura, Katsunori Ikari & Taisuke Tomatsu

  2. Department of Internal Medicine, Institute of Rheumatology, Tokyo Women's Medical University, Tokyo, Japan

    Hiroshi Okamoto, Toru Yago, Takefumi Furuya, Yuki Nanke, Shigeru Kotake & Makoto Soejima

Authors
  1. Shigeki Momohara
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  2. Hiroshi Okamoto
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  3. Toru Yago
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  4. Takefumi Furuya
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  5. Yuki Nanke
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  6. Shigeru Kotake
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  7. Makoto Soejima
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  8. Tamao Mizumura
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  9. Katsunori Ikari
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  10. Taisuke Tomatsu
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Correspondence to Shigeki Momohara.

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Momohara, S., Okamoto, H., Yago, T. et al. The study of bone mineral density and bone turnover markers in postmenopausal women with active rheumatoid arthritis. Mod Rheumatol 15, 410–414 (2005). https://doi.org/10.1007/s10165-005-0435-5

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  • DOI: https://doi.org/10.1007/s10165-005-0435-5

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