Effect of Endogenous Subclinical Hyperthyroidism on Bone Metabolism and Bone Mineral Density in Premenopausal Women

Background And Objective:Osteoporosis is a common bone disorder that increases susceptibility to fragility bone fractures. The clinical and public health repercussions of osteoporosis are huge due to the morbidity, mortality, and cost of medical care linked with fragility fractures. Clinical assessment of osteoporotic risk factors can help to identify candidates at an early stage that will benefit from medical intervention and potentially lowering the morbidity and mortality seen with fractures and complications. Given this, research is ongoing to evaluate the association of osteoporosis with some novel or less well-studied risk factors/bio-markers such as uric acid (UA).Discussion:Uric acid’s antioxidant activity has been proposed to be one of the factors responsible for increasing longevity and lowering rates of age-related cancers during primate evolution, the level of which increased markedly due to loss of uricase enzyme activity (mutational silencing). Accumulated evidence shows that oxidative stress is the fundamental mechanism of age-related bone loss and acts via enhancing osteoclastic activity and increasing bone resorption. Antioxidant substances such as ascorbic acid scavenge free radicals are positively related to bone health. Thus, it is hypothesized that uric acid holds bone-protective potential owing to its potent antioxidative property. Several correlation studies have been conducted globally to investigate the relationship between serum uric acid with bone mineral density and osteoporosis. Few pre-clinical studies have tried to investigate the interaction between uric acid and bone mineral density and reported important role played via Runt-related transcription factor 2 (RUNX2)/core-binding factor subunit alpha-1 (CBF-alpha-1), Wingless-related integration site (Wnt)-3a/β-catenin signaling pathway and 11β Hydroxysteroid Dehydrogenase type 1.Conclusion:In this review, the authors provided a comprehensive summary of the literature related to association studies reported in humans as well work done until date to understand the potential cellular and molecular mechanisms that interplay between uric acid and bone metabolism.

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POS0841 RISK FACTORS OF LOW BONE MINERAL DENSITY IN WOMEN WITH SYSTEMIC SCLEROSIS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.1339 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 674.2-675

Author(s):

A. Efremova ◽

N. Toroptsova ◽

N. Demin ◽

O. Dobrovolskaya ◽

O. Nikitinskaya

Keyword(s):

Risk Factors ◽

Bone Mineral Density ◽

Systemic Sclerosis ◽

Postmenopausal Women ◽

Bone Mineral ◽

Cumulative Dose ◽

Premenopausal Women ◽

C Reactive Protein ◽

Mineral Density ◽

Reactive Protein

Background:Chronic inflammatory rheumatic diseases are risk factors of bone loss and fractures. Systemic sclerosis (SSc) has been recognized to be another potential inflammatory joint disease that may affect bone tissue.Objectives:to evaluate bone mineral density (BMD) and risk factors of low BMD in women with SSc.Methods:173 women, among them 110 postmenopausal (median age 60[55,63] years) and 63 premenopausal (median age 35[31,44] years). BMD was measured at lumbar spine (LS), femoral neck (FN) and total hip (TH) by dual energy X-ray absorptiometry (DXA, Hologic 4500A). Low BMD was diagnosed if the T-score was < -1.0 standard deviation (SD) in postmenopausal women and if the Z-score was < -2.0 SD in premenopausal women. The relationship between BMD and SSc patients’ characteristics was evaluated using univariate linear regression analysis.Results:Low BMD was found in 66% patients: 79% - in postmenopausal and 18% - in premenopausal women. Among postmenopausal persons osteoporosis was discovered in 47% and osteopenia – in 32% cases. In postmenopausal woman BMD of LS, FN and TH were associated with body mass index (BMI) (β=0.27, p=0.010; β=0.47, p<0,001 and β=0.45, p<0,001, respectively), duration of glucocorticoids (GCs) using (β=-0.31, p=0.008; β=-0.34, p=0.003 and β=-0.27, p=0.022, respectively); BMD of FN and TH with C-reactive protein (β= -0.32, p=0.016 and β= -0.29, p=0.029, respectively) and LS BMD with current and cumulative GCs dose (β= -0.24, p=0.039 and β= -0.29, p=0.014, respectively). In premenopausal women BMD of LS, FN and TH were associated with BMI (β=0.51, p<0,001; β=0.45, p=0.003 and β=0.47, p=0.002, respectively), duration of GCs using (β= -0.45, p=0.004; β= -0.47, p=0.003 and β= -0.48, p=0.002, respectively) and GCs cumulative dose (β= -0.48, p=0.002; β= -0.51, p=0.001 and β= -0.46, p=0.004, respectively); BMD of FN and TH with 25(ОН)D level (β=0.52, p=0.008 and β=0.54, p=0.005, respectively), and LS BMD with SSc duration (β= -0.44, p=0.004).Conclusion:Low BMD was diagnosed in 66% of women with SSc. Low BMI, GCs cumulative dose and duration of GCs using were independent risk factors for low BMD in both premenopausal and postmenopausal persons. Additional factors as SSc duration and low vitamin D level were found out for premenopausal and current GCs dose and C-reactive protein level for postmenopausal women.Disclosure of Interests:None declared

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