scholarly journals Relation between bone mineral density and IL-17 serum levels in Serbian patients with early Rheumatoid arthritis

Open Medicine ◽  
2014 ◽  
Vol 10 (1) ◽  
Author(s):  
Voja Pavlovic ◽  
Aleksandar Dimic ◽  
Sasa Milenkovic ◽  
Dane Krtinic ◽  
Ivana Aleksic
Keyword(s):  
Rheumatoid Arthritis ◽  
Bone Mineral Density ◽  
Disease Activity ◽  
Bone Mineral ◽  
Serum Levels ◽  
Mineral Density ◽  
Serum Samples ◽  
Das28 Score ◽  
Early Ra ◽  
Control Serum

AbstractRheumatoid arthritis (RA) is a chronic inflammatory disease characterized by synovial inflammation and destruction of joint cartilage and bone. Different cytokines play important role in the processes that cause articular destruction and extra-articular manifestations in RA. The contribution of cytokines representing the Th1 (INF-γ), Th2 (IL-4) and IL-17A to the pathogenesis of early RA and bone mineral density (BMD) loss in still poorly understood. Serum samples of 38 early RA patients were evaluated for erythrocyte sedimentation rate (ESR), rheumatoid factor (RF), C-reactive protein (CRP), anti-cyclic citrullinated peptide antibodies (anti-CCP) and for the tested cytokines (IL-17A, IL-4 and INF-γ). BMD was evaluated by dualenergyX-ray absorptiometry (DXA). Disease activity score (DAS28) calculation was assessed for all patients. Control serum samples were obtained from 34 healthy volunteers. The levels of tested cytokines were significantly higher (IL-17A, p<0.001; INF-γ, P<0.001; IL-4, P<0.01) in patients with early RA, compared to the healthy controls. In early RA patients, strong correlation of serum IL-17A was found with DAS28, ESR and CRP. Also, a significant negative correlation was found between serum INF-γ levels and the DAS28 score. Significantly positive correlation of BMD values and CRP, DAS28 IL-17A were also demonstrated. DXA analysis revealed that the most common site for osteoporosis was the lumbar spine followed by the femoral neck. BMD values significantly correlated with CRP, DAS28 score and IL-17A serum levels. The mean serum IL-17A levels, in patients with early RA, corresponded with disease activity, severity and BMD loss, indicating the potential usefulness of serum IL-17A in defining the disease activity and bone remodeling.

scholarly journals SAT0034 CLINICAL SIGNIFICANCE OF ANTI-CARBAMYLATED PROTEIN ANTIBODIES IN PREMENOPAUSAL RHEUMATOID ARTHRITIS WOMEN: RELATION TO DISEASE ACTIVITY AND BONE LOSS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 947.2-947
Author(s):  
R. Elnemr ◽  
R. Bastawy ◽  
R. Ghazala ◽  
M. Abdelrazek ◽  
N. Elsawy
Keyword(s):  
Rheumatoid Arthritis ◽  
Physical Activity ◽  
Bone Mineral Density ◽  
Body Mass Index ◽  
Serum Level ◽  
Bone Loss ◽  
Disease Activity ◽  
Bone Mineral ◽  
Mineral Density ◽  
Local Bone

Background:Anti carbamylated protein anti carP are present in patients with Rheumatoid Arthritis RA and are associated with erosions. However their association with systemic or local bone loss in RA patients is still not confirmed.Objectives:The purpose of this study was to measure the serum level of anti carP in premenopausal women with RA and determine its relation to disease activity and bone loss.Methods:This case control study was conducted on forty eight RA premenopausal female patients diagnosed according to 2010 ACR/EULAR criteria and forty eight ages and body mass index matched healthy premenopausal females. RA patients with other autoimmune diseases, viral hepatitis malignancy or erosive joint disease and systemic diseases that affect bone quality were excluded from the study. All RA women were subjected to history taking, clinical examination, assessment of disease activity using disease activity score-28 DAS28 and clinical disease activity index CDAI functional assessment using health assessment questionnaire HAQ physical activity assessment using international physical activity questionnaire short form IPAQ fatigue assessment using modified fatigue impact scale MFIS, routine laboratory investigations, serological tests as well as Anti carP using ELISA kit. Moreover the bone mineral density was measured by a lunar Prodigy Advanced DEXA scanner system and plain x-ray of both hands and wrists in the anteroposterior view was done to assess the juxta articular osteopenia and erosions.Results:Anti carP level was significantly higher in RA patients than in healthy controls table 1. The serum level of anti carP had a significant positive correlation with RA DAS, CDAI, HAQ, IPAQ, MFIS and erosion and joint space narrowing in original sharp score. Also the anti carP had a significant negative correlation with the bone mineral density BMD of spine. The AUC of anti carP level showed a high level of accuracy AUC 0.857 figure 1 and the calculated cutoff value >65 can precisely discriminate subjects with RA from those without RA with 85.42% sensitivity and 85.11% specificity.Table 1.Comparison between the patient and healthy groups according to anti carp levelAnti-carpRA patientsHealthy controlUpMin – Max15.0 – 90.01.0 – 78.50322.0*<0.001*Mean ± SD71.24 ± 14.7045.99 ± 21.99Median (IQR)72.75 (70.5–78.3)55.0 (32.5–61.5)Figure 1.ROC curve for anti carP to diagnose RA patients from healthy subjectsConclusion:Anti carbamylated antibodies were higher in premenopausal RA women compared to ages and body mass index matched healthy women. Anti carP are associated with higher RA disease activity, increased disability and decreased physical activity. Moreover anti carP are associated with systemic trabecular bone loss manifested by decreased bone mineral density of the spine as well as local bone loss as manifested by increased number of joint erosions in premenopausal RA women.References:[1] Regueiro C, Ortiz AM, Boveda MD, Castañeda S, Gonzalez-Alvaro I, Gonzalez A. Association of high titers of anti-carbamylated protein antibodies with decreased bone mineral density in early arthritis patients. PLoS ONE 2018; 13(8):e0202583.Disclosure of Interests:None declared

scholarly journals Time-averaged disease activity of rheumatoid arthritis associated with long-term bone mineral density changes

2020 ◽  
Vol 11 ◽  
pp. 204062232098151
Author(s):  
Chung-Yuan Hsu ◽  
Jia-Feng Chen ◽  
Yu-Jih Su ◽  
Ying-Chou Chen ◽  
Han-Ming Lai ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Bone Mineral Density ◽  
Bone Loss ◽  
Disease Activity ◽  
Bone Mineral ◽  
Osteoporosis Treatment ◽  
High Disease Activity ◽  
Mineral Density

Background: Rheumatoid arthritis (RA) is associated with poor bone mineral density (BMD). We designed the current study owing to the lack of long-term prospective studies regarding whether a high disease activity leads to increased bone loss. Methods: We have continually enrolled patients with RA. According to the average disease activity score in 28 joints based on the erythrocyte sedimentation rate (DAS28-ESR) during follow-up, the patients were classified into remission, low disease activity, and moderate or high disease activity groups. Patients were examined with dual-energy X-ray absorptiometry at baseline and after 3 years of follow-up. BMD changes were compared among the groups. Results: We have studied 477 patients. Overall BMD was significantly reduced from baseline to the 3-year follow-up ( p < 0.05). After stratifying according to the time-averaged DAS28-ESR levels and use of anti-osteoporosis treatment (AOT), the BMD values of the femur and spine significantly increased in patients in the remission group with AOT. The BMD changes of different DAS28-ESR patients were further compared using the generalized estimation equation model. For the patients on AOT, the negative change in femoral BMD values of the moderate or high activity group was significant when compared with the remission group with positive BMD changes (regression coefficient, –0.038; 95% confidence interval, –0.055 to –0.021). Conclusion: For RA patients, if remission is achieved, AOT can better improve BMD, especially in the femur. In addition, moderate or high disease activity will lead to significant bone loss; therefore, disease activity must be actively controlled.

Sign in / Sign up

Export Citation Format

Share Document