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Radiographic joint destruction in postmenopausal rheumatoid arthritis is strongly associated with generalised osteoporosis.

Forsblad D'Elia, H; Larsen, A; Waltbrand, E; Kvist, G; Mellström, D; Saxne, Tore LU ; Ohlsson, C; Nordborg, E and Carlsten, H (2003) In Annals of the Rheumatic Diseases 62(7). p.617-623
Abstract
Objectives: To investigate determinants of joint destruction and reduced bone mineral density (BMD) in postmenopausal women with active rheumatoid arthritis (RA) not treated with bisphosphonates or hormone replacement therapy and to evaluate if there are common markers of erosive disease and bone loss.



Methods: BMD was measured using dual x ray absorptiometry and joint damage was examined by x ray examination according to the Larsen method in 88 patients with RA. Associations between BMD and Larsen score, and between demographic and disease related variables, including proinflammatory cytokines, HLA-DR4 epitopes, and markers of bone and cartilage turnover, were examined bivariately by simple and multiple linear... (More)
Objectives: To investigate determinants of joint destruction and reduced bone mineral density (BMD) in postmenopausal women with active rheumatoid arthritis (RA) not treated with bisphosphonates or hormone replacement therapy and to evaluate if there are common markers of erosive disease and bone loss.



Methods: BMD was measured using dual x ray absorptiometry and joint damage was examined by x ray examination according to the Larsen method in 88 patients with RA. Associations between BMD and Larsen score, and between demographic and disease related variables, including proinflammatory cytokines, HLA-DR4 epitopes, and markers of bone and cartilage turnover, were examined bivariately by simple and multiple linear regression analyses.



Results: 49/88 (56%) patients had osteoporosis in at least one site. Reduced BMD and increased joint destruction were associated with: at the forearm and femoral neck, high Larsen score, low weight, and old age (R2=0.381, p<0.001; R2=0.372, p<0.001, respectively); at the total hip, low weight, high Larsen score, and dose of injected glucocorticosteroids (R2=0.435, p<0.001); at the lumbar spine, low weight, reduced cartilage oligomeric matrix protein, and increased carboxyterminal propeptide of type I procollagen (R2=0.248, p<0.001). Larsen score was associated with long disease duration and increased C reactive protein (CRP) (R2=0.545, p<0.001).



Conclusions: Osteoporosis is common in postmenopausal patients with RA. Low weight and high Larsen score were strongly associated with BMD reduction. Increased CRP and long disease duration were determinants of erosive disease in postmenopausal women with RA. These findings indicate common mechanisms of local and generalised bone loss in RA. (Less)
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author
organization
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type
Contribution to journal
publication status
published
subject
in
Annals of the Rheumatic Diseases
volume
62
issue
7
pages
617 - 623
publisher
British Medical Association
external identifiers
  • wos:000183545000006
  • pmid:12810422
  • scopus:0038208285
ISSN
1468-2060
DOI
10.1136/ard.62.7.617
language
English
LU publication?
yes
id
86db9efa-5124-4d07-8a58-5842fd8b708a (old id 115907)
alternative location
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12810422&dopt=Abstract
date added to LUP
2007-07-04 12:23:10
date last changed
2018-10-03 10:27:03
@article{86db9efa-5124-4d07-8a58-5842fd8b708a,
  abstract     = {Objectives: To investigate determinants of joint destruction and reduced bone mineral density (BMD) in postmenopausal women with active rheumatoid arthritis (RA) not treated with bisphosphonates or hormone replacement therapy and to evaluate if there are common markers of erosive disease and bone loss.<br/><br>
<br/><br>
Methods: BMD was measured using dual x ray absorptiometry and joint damage was examined by x ray examination according to the Larsen method in 88 patients with RA. Associations between BMD and Larsen score, and between demographic and disease related variables, including proinflammatory cytokines, HLA-DR4 epitopes, and markers of bone and cartilage turnover, were examined bivariately by simple and multiple linear regression analyses.<br/><br>
<br/><br>
Results: 49/88 (56%) patients had osteoporosis in at least one site. Reduced BMD and increased joint destruction were associated with: at the forearm and femoral neck, high Larsen score, low weight, and old age (R2=0.381, p&lt;0.001; R2=0.372, p&lt;0.001, respectively); at the total hip, low weight, high Larsen score, and dose of injected glucocorticosteroids (R2=0.435, p&lt;0.001); at the lumbar spine, low weight, reduced cartilage oligomeric matrix protein, and increased carboxyterminal propeptide of type I procollagen (R2=0.248, p&lt;0.001). Larsen score was associated with long disease duration and increased C reactive protein (CRP) (R2=0.545, p&lt;0.001).<br/><br>
<br/><br>
Conclusions: Osteoporosis is common in postmenopausal patients with RA. Low weight and high Larsen score were strongly associated with BMD reduction. Increased CRP and long disease duration were determinants of erosive disease in postmenopausal women with RA. These findings indicate common mechanisms of local and generalised bone loss in RA.},
  author       = {Forsblad D'Elia, H and Larsen, A and Waltbrand, E and Kvist, G and Mellström, D and Saxne, Tore and Ohlsson, C and Nordborg, E and Carlsten, H},
  issn         = {1468-2060},
  language     = {eng},
  number       = {7},
  pages        = {617--623},
  publisher    = {British Medical Association},
  series       = {Annals of the Rheumatic Diseases},
  title        = {Radiographic joint destruction in postmenopausal rheumatoid arthritis is strongly associated with generalised osteoporosis.},
  url          = {http://dx.doi.org/10.1136/ard.62.7.617},
  volume       = {62},
  year         = {2003},
}