Abstract
BackgroundRheumatoid arthritis (RA) is known to cause secondary osteoporosis and fragility fractures. This study aimed to identify biomarkers predictive of bone mineral density (BMD) change at three anatomical sites in patients with RA.MethodsWe conducted a prospective longitudinal study in patients with RA. In 2012, we recruited 379 patients from an RA cohort, 329 of whom underwent evaluation of blood and urine biomarkers together with measurement of BMD in the lumbar spine, proximal femur, and distal forearm. The BMD in these three regions was reassessed in 2014. We performed multivariate linear regression analysis to identify those factors associated with BMD change.ResultsThe averages of age, body mass index, and disease activity score in 28 joints (DAS28) at baseline were 63.2 (minimum to maximum, 32–85), 21.3 (12.3–30.0), and 3.2 (0.1–5.9), respectively. Univariate analysis showed that the annual BMD change was significantly associated with the use of steroid, bisphosphonate (BP) or vitamin D (VitD), and serum homocysteine in the lumber spine; DAS28, the use of BP or VitD, CRP, and anti-cyclic citrullinated peptide antibody (ACPA) in the proximal femur; and the dosage of MTX, the use of BP or VitD, and serum tartrate-resistant acid phosphatase 5b (TRACP-5b) in the distal forearm, respectively.ConclusionsPredictive biomarkers for BMD change in RA patients differ at each anatomical site. Practitioners should treat each anatomical site with different markers and prescribe osteoporosis drugs to prevent fractures for RA patients.
Highlights
Rheumatoid arthritis (RA) is a predominantly inflammatory arthritis and a well-known cause of secondary osteoporosis
We found that distinct biomarkers are effective to predict the changes of bone mineral density in the lumbar spine, the proximal femur, and the distal forearm in patients with rheumatoid arthritis
Study plan and participants We used the Kyoto University Rheumatoid Arthritis Management Alliance (KURAMA) cohort, which was initiated in May 2011 for prospective monitoring of the changes in condition of patients with RA, with the data to be prospectively used for clinical research [16, 17]
Summary
Rheumatoid arthritis (RA) is a predominantly inflammatory arthritis and a well-known cause of secondary osteoporosis. Osteoporosis increases the possibility of fragility fractures of spine, hip, and other sites, which. Osteoporosis increases the risk of fractures at various sites of the body. That study did not report site-specific risk factors. Previous large cohort studies have reported that the risk factors for fractures are similar but distinct for different anatomical sites in patients with RA [7,8,9,10]. To introduce preventive measures against these fractures, it is critical to identify any site-specific biomarkers, but these remain to be investigated. Rheumatoid arthritis (RA) is known to cause secondary osteoporosis and fragility fractures. This study aimed to identify biomarkers predictive of bone mineral density (BMD) change at three anatomical sites in patients with RA
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