绝经后类风湿关节炎女性骨吸收与放射学进展相关.

Bone resorption was correlated with radiologic progression in postmenopausal women with rheumatoid arthritis.

Objectives To determine the levels of bone turnover markers in patients with rheumatoid arthritis ( ＲA) and the correlation with disease activity index，bone mineral density ( BMD ) ，and radiographic progression． Methods Sixty-eight postmenopausal women with ＲA were recruited in our study． Serologic measurement including erythrocyte sedimentation rate (ESR) ，C-reactive protein (CRP) ，rheumatoid factor ( ＲF) and anti-cyclic citrullinated peptide (anti-CCP) were analyzed． Calcium，vitamin D，bone alkaline phosphatase (BAP) β-crosslaps were also detected． Bone mineral density (BMD，g /cm2 ) of the lumbar spine and the left femoral neck was measured using dual-energy X-ray absorptiometry (DXA) ． DAS28 and Sharp score were separately calculated for disease activity and radiographic progression evaluation． Spearman correlation analysis was conducted between clinical biomarkers and disease indexes． Results The overall rate of patient with abnormal BMD was 94. 12 %，with 29. 41% (20 /68) of osteopenia and 64. 71% (44 /68) of osteoporosis，respectively． ESR，CRP，and DAS28 were significantly correlated with each other showing consistent disease activity ( P ＜ 0. 05) ． Serum β-crosslaps level (452. 87 ± 202. 40ug /l) was not correlated with any of disease acidity markers (all P ＞ 0. 05) but was positively correlated with Sharp score (150. 76 ± 59. 71) in postmenopausal women with RA (r = 0. 776，P = 1 × 10-6 ) ． Conclusion Osteopenia and osteoporosis are predominant in RA which might be related to disease activity and /or structural damage． β-crosslaps implies radiographic progression instead of disease activity． [ABSTRACT FROM AUTHOR]

目的探讨绝经后类风湿关节炎(rheumatoid arthritis，RA) 患者骨代谢指标与疾病活动指标、骨矿物质密度(bone mineral density，BMD) 和放射学进展的相互关系。方法本研究共募集了68 例绝经后ＲA 患者。血清检测指标包括红细胞沉 降率(ESＲ) 、C 反应蛋白(CRP) 、类风湿因子(RF) 和抗环胍氨酸肽抗体(CCP) 。同时检测了钙、维生素D、骨碱性磷酸酶 (BAP) 和β 胶原特殊序列( β-crosslaps) 的水平。采用双能X 线骨吸收仪( DXA) 测量腰椎和左股骨颈的BMD(g /cm2 ) 。 DAS28 和Sharp 评分分别用于计算疾病活动度和放射学进展评估。运用Spearman 相关分析对临床血清标记和疾病指标的相 关性进行分析。结果纳入患者的异常BMD 比率为94. 12%，其中29. 41% (20 /68) 为骨量减少，而64. 71% (44 /68) 为骨质 疏松。ESR、CRP 和DAS28 之间显著相关(P ＜ 0. 05) ，均提示疾病活动。血清β-crosslaps 水平与任一疾病活动指标均无相关 性(p 均＞ 0. 05) ，但与Sharp 评分呈正相关(r = 0. 776，P = 1 × 10-6 ) 。结论绝经后ＲA 患者骨量减少及骨质疏松现象突出， 可能与疾病活动和/或关节结构破坏有关。β-crosslaps 是与放射学进展相关而与疾病活动无关的有价值的血清标记。 [ABSTRACT FROM AUTHOR]

Copyright of Chinese Journal of Osteoporosis is the property of Chinese Journal of Osteoporosis and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)