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Ji R, Yang L, Shi G, Sun J, Cao P. Correlation of serum matrix metalloproteinase 3 with osteoporosis in patients of postmenopausal rheumatoid arthritis. Hum Immunol 2024; 85:110807. [PMID: 38701721 DOI: 10.1016/j.humimm.2024.110807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 04/14/2024] [Accepted: 04/23/2024] [Indexed: 05/05/2024]
Abstract
Osteoporosis (OP) is a common complication of postmenopausal women with rheumatoid arthritis (RA). Herein, the objective of our study was to explore the correlation between serum matrix metalloproteinase 3 (MMP3) and OP among postmenopausal women with RA to foster better diagnosis and treatment. A total of 208 elderly postmenopausal women with RA were included in this study, with 83 patients diagnosed with OP after RA diagnosis and 125 patients without OP. Serum MMP3 levels and bone mineral density (BMD) were measured and compared. The predictive value of serum MMP3 for OP in this population was also analyzed using receiver operating curve (ROC) analysis. Postmenopausal women with RA and OP diagnosis had markedly higher serum MMP3 levels, compared to those without OP. ROC analysis showed that serum MMP3 had predictive value for OP. Additionally, a negative correlation was observed between serum MMP3 levels and BMD. High serum MMP3 levels were also found to be associated with high abnormal bone metabolism. We found that serum MMP3 levels are strongly correlated with OP in postmenopausal women with RA and that elevated levels of serum MMP3 are linked to low BMD and high abnormal bone metabolism. Serum MMP3 may be a useful biomarker for predicting OP in this population, and could potentially aid in the development of targeted prevention and treatment strategies.
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Affiliation(s)
- Rong Ji
- Department of Rheumatology, Jiangnan University Medical Center, Wuxi 214000, Jiangsu, China
| | - Lei Yang
- Department of Geriatrics, Jiangnan University Medical Center, Wuxi 214000, Jiangsu, China
| | - Guoxun Shi
- Department of Rheumatology, Jiangnan University Medical Center, Wuxi 214000, Jiangsu, China
| | - Jianming Sun
- Urology Surgery, the 904th Hospital of Joint Logistic Support Force of PLA, Wuxi 214000, Jiangsu, China
| | - Pei Cao
- Department of Geriatrics, Jiangnan University Medical Center, Wuxi 214000, Jiangsu, China.
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Kodama R, Muraki S, Iidaka T, Oka H, Teraguchi M, Kagotani R, Asai Y, Hashizume H, Yoshida M, Kawaguchi H, Nakamura K, Akune T, Tanaka S, Yoshimura N. Serum levels of matrix metalloproteinase-3 and autoantibodies related to rheumatoid arthritis in the general Japanese population and their association with osteoporosis and osteoarthritis: the ROAD study. J Bone Miner Metab 2018; 36:246-253. [PMID: 28365812 DOI: 10.1007/s00774-017-0834-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 03/12/2017] [Indexed: 10/19/2022]
Abstract
To purpose of this study was to reveal the mean levels and positive proportion of serological markers related to rheumatoid arthritis, and clarify their relationship with osteoporosis and hand osteoarthritis (OA). A total of 1546 participants from the third survey of the research on osteoarthritis/osteoporosis against disability study were enrolled in the current study. Using participant blood samples, the levels of anti-cyclic citrullinated protein (CCP) antibody, rheumatoid factor (RF), matrix metalloproteinase-3 (MMP-3), C-reactive protein (CRP), and high-sensitivity CRP (hsCRP) were measured. Subjects with higher than normal levels were defined as being positive. Osteoporosis was defined according to the recommendations set by World Health Organization criteria in 1994. Radiographic hand OA was evaluated using the modified Kellgren-Lawrence (KL) scale. The positive proportion of anti-CCP antibody, RF, MMP-3, CRP, and hsCRP was 1.8, 7.1, 15.0, 6.7, and 6.4%, respectively. MMP-3 was associated with age, and was significantly higher in men than in women. Positive MMP-3 was not significantly related to osteoporosis or severe hand OA (KL grade ≥3) after adjustment for other factors including age, sex, and body mass index. The results from this study clarified the values and positive proportion of RA-related markers and revealed their relationship with osteoporosis and hand OA.
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Affiliation(s)
- Rie Kodama
- Department of Orthopedic Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shigeyuki Muraki
- Department of Joint Disease Research, 22nd Century Medical and Research Center, Faculty of Medicine, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Toshiko Iidaka
- Department of Joint Disease Research, 22nd Century Medical and Research Center, Faculty of Medicine, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Hiroyuki Oka
- Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical and Research Center, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masatoshi Teraguchi
- Department of Orthopedic Surgery, Wakayama Medical University, Wakayama, Japan
| | - Ryohei Kagotani
- Department of Orthopedic Surgery, Wakayama Medical University, Wakayama, Japan
| | - Yoshiki Asai
- Department of Orthopedic Surgery, Wakayama Medical University, Wakayama, Japan
| | - Hiroshi Hashizume
- Department of Orthopedic Surgery, Wakayama Medical University, Wakayama, Japan
| | - Munehito Yoshida
- Department of Orthopedic Surgery, Wakayama Medical University, Wakayama, Japan
| | - Hiroshi Kawaguchi
- Department of Orthopedic Surgery, Japan Community Healthcare Organization Tokyo Shinjuku Medical Center, Tokyo, Japan
| | - Kozo Nakamura
- National Rehabilitation Center for Persons with Disabilities, Saitama, Japan
| | - Toru Akune
- National Rehabilitation Center for Persons with Disabilities, Saitama, Japan
| | - Sakae Tanaka
- Department of Orthopedic Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Noriko Yoshimura
- Department of Joint Disease Research, 22nd Century Medical and Research Center, Faculty of Medicine, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan.
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Correlation between hand bone mineral density and joint destruction in established rheumatoid arthritis. J Orthop 2017; 14:461-465. [PMID: 28831233 DOI: 10.1016/j.jor.2017.07.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 06/05/2017] [Accepted: 07/30/2017] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE We aimed to clarify the correlation between bone mineral density (BMD) and the modified total Sharp score of the hand in Japanese patients with established rheumatoid arthritis (RA). METHODS We examined the hands of 57 patients who had RA for more than 20 years. BMD for the whole hand was measured using dual-energy x-ray absorptiometry. Concurrently, the hands were analyzed using radiography to estimate the van der Heijde-modified total Sharp score (vdH-S). RESULTS The patients were all women with a median age of 69.7 years and RA disease duration of 29.9 years. The correlation coefficients were -0.513 (P < 0.0001) for hand BMD and vdH-S of the hand, -0.576 (P < 0.0001) for hand BMD and the erosion score of the vdH-S, and -0.339 (P < 0.0001) for hand BMD and the joint narrowing score of the vdH-S. CONCLUSIONS Hand BMD is correlated with the vdH-S in long-established RA. The hand BMD is important for structural assessment of the hand. Additionally, we may be able to predict the vdH-S of the hand on the basis of the hand BMD in long-established RA.
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Rogers TS, Demmer E, Rivera N, Gertz ER, German JB, Smilowitz JT, Zivkovic AM, Van Loan MD. The role of a dairy fraction rich in milk fat globule membrane in the suppression of postprandial inflammatory markers and bone turnover in obese and overweight adults: an exploratory study. Nutr Metab (Lond) 2017; 14:36. [PMID: 28529534 PMCID: PMC5436451 DOI: 10.1186/s12986-017-0189-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Accepted: 05/08/2017] [Indexed: 12/19/2022] Open
Abstract
Background Inflammation is associated with increased bone resorption; the role of inflammation in postprandial bone turnover has not been explored. Consumption of milk fat globule membrane (MFGM) reduces inflammation in animal models. This study aimed to measure postprandial changes in bone turnover after intake of high saturated fat test meals, with- and without the anti-inflammatory ingredient MFGM. Methods Subjects (n = 36 adults) were obese (BMI 30–39.9 kg/m2) or overweight (BMI 25–29.9 kg/m2) with two traits of Metabolic Syndrome. Subjects consumed a different test meal on four occasions at random; blood draws were taken at baseline and 1, 3, and 6 h postprandial. Test meals included whipping cream (WC), WC + MFGM, palm oil (PO) and PO + MFGM. Biomarkers of bone turnover and inflammation were analyzed from all four time points. Results Test meal (treatment) by time interactions were significant for bone resorption marker C-telopeptide of type 1 collagen (CTX) (p < 0.0001) and inflammatory marker interleukin 10 (IL-10) (p = 0.012). Significant differences in overall postprandial response among test meals were found for CTX and soluble intercellular adhesion molecule (sICAM), with the greatest overall postprandial suppression of CTX occurring in meals containing MFGM. However, test meal by MFGM interactions were non- significant for bone and inflammatory markers. Correlations between CTX and inflammatory markers were non-significant. Conclusion This exploratory analysis advances the study of postprandial suppression of bone turnover by demonstrating differing effects of high SFA meals that contained MFGM; however MFGM alone did not directly moderate the difference in postprandial CTX response among test meals in this analysis. These observations may be useful for identifying foods and ingredients which maximize the suppression of bone resorption, and for generating hypotheses to test in future studies examining the role of inflammation in postprandial bone turnover. Trial registration Clinicaltrials.gov NCT01811329. Registered 11 March 2013. Electronic supplementary material The online version of this article (doi:10.1186/s12986-017-0189-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Tara S Rogers
- Department of Nutrition, University of California, Davis, 1 Shields Avenue, Davis, CA 95616 USA.,Center for Musculoskeletal Health, University of California, Davis Medical Center, 4625 2nd Avenue, Sacramento, CA 95817 USA
| | - Elieke Demmer
- Department of Nutrition, University of California, Davis, 1 Shields Avenue, Davis, CA 95616 USA
| | - Nancy Rivera
- Department of Nutrition, University of California, Davis, 1 Shields Avenue, Davis, CA 95616 USA
| | - Erik R Gertz
- USDA, Agricultural Research Service, Western Human Nutrition Research Center, 430 West Health Sciences Drive, Davis, CA 95616 USA
| | - J Bruce German
- Foods for Health Institute, University of California, Davis, 1 Shields Avenue, Davis, CA 95616 USA.,Department of Food Science & Technology, University of California, Davis, 1 Shields Avenue, Davis, CA 95616 USA
| | - Jennifer T Smilowitz
- Foods for Health Institute, University of California, Davis, 1 Shields Avenue, Davis, CA 95616 USA.,Department of Food Science & Technology, University of California, Davis, 1 Shields Avenue, Davis, CA 95616 USA
| | - Angela M Zivkovic
- Department of Nutrition, University of California, Davis, 1 Shields Avenue, Davis, CA 95616 USA.,Foods for Health Institute, University of California, Davis, 1 Shields Avenue, Davis, CA 95616 USA
| | - Marta D Van Loan
- Department of Nutrition, University of California, Davis, 1 Shields Avenue, Davis, CA 95616 USA.,USDA, Agricultural Research Service, Western Human Nutrition Research Center, 430 West Health Sciences Drive, Davis, CA 95616 USA
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Mochizuki T, Yano K, Ikari K, Kawakami K, Hiroshima R, Koenuma N, Ishibashi M, Shirahata T. Hip structure analysis by DXA of teriparatide treatment: A 24-month follow-up clinical study. J Orthop 2016; 13:414-8. [PMID: 27656075 DOI: 10.1016/j.jor.2016.09.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Accepted: 09/02/2016] [Indexed: 10/21/2022] Open
Abstract
OBJECTIVE The objective of this study was to perform a hip structure analysis (HSA) of teriparatide (TPTD) treatment in women with postmenopausal osteoporosis. METHODS The study included 96 patients with postmenopausal osteoporosis and received 20 μg TPTD daily. HSA was performed by dual-energy X-ray absorptiometry. RESULTS The percent changes from baseline for the cross-sectional moment of inertia, section modulus, buckling ratio, and femoral strength index based on HSA results were 9.8% (p < 0.01), 10.7%, 3.3%, and 14.9% (p < 0.01), respectively, at 24 months. CONCLUSION Based on the HSA results obtained with DXA, TPTD was effective for hip structures.
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Affiliation(s)
- Takeshi Mochizuki
- Department of Rheumatology and Orthopaedic Surgery, Kamagaya General Hospital, Chiba, Japan
| | - Koichiro Yano
- Institute of Rheumatology, Tokyo Women's Medical University, Tokyo, Japan
| | - Katsunori Ikari
- Institute of Rheumatology, Tokyo Women's Medical University, Tokyo, Japan
| | - Kosei Kawakami
- Department of Rheumatology and Orthopaedic Surgery, Kamagaya General Hospital, Chiba, Japan
| | - Ryo Hiroshima
- Department of Rheumatology and Orthopaedic Surgery, Kamagaya General Hospital, Chiba, Japan
| | - Naoko Koenuma
- Department of Rheumatology and Orthopaedic Surgery, Kamagaya General Hospital, Chiba, Japan
| | - Mina Ishibashi
- Department of Rheumatology and Orthopaedic Surgery, Kamagaya General Hospital, Chiba, Japan
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Sugiguchi S, Goto H, Inaba M, Nishizawa Y. Preferential reduction of bone mineral density at the femur reflects impairment of physical activity in patients with low-activity rheumatoid arthritis. Mod Rheumatol 2014. [DOI: 10.3109/s10165-009-0242-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Yoshino K, Momohara S, Ikari K, Kawamura K, Mochizuki T, Iwamoto T, Niki Y, Saitou S, Tomatsu T. Acute destruction of the hip joints and rapid resorption of femoral head in patients with rheumatoid arthritis. Mod Rheumatol 2014. [DOI: 10.3109/s10165-006-0516-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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8
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Anagnostis P, Vakalopoulou S, Vyzantiadis TA, Charizopoulou M, Karras S, Goulis DG, Karagiannis A, Gerou S, Garipidou V. The clinical utility of bone turnover markers in the evaluation of bone disease in patients with haemophilia A and B. Haemophilia 2013; 20:268-75. [PMID: 24118364 DOI: 10.1111/hae.12271] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/05/2013] [Indexed: 01/01/2023]
Abstract
Haemophilia A and B have been associated with increased prevalence of low bone mineral density (BMD). However, the utility of bone turnover markers (BTM) remains unknown. The aim of this study was to evaluate bone metabolism in men with haemophilia and to investigate associations between BTM and bone disease. Serum N- (NTX-I), C-terminal telopeptide of type I collagen (CTX-I) and tartrate-resistant acid phosphatase band-5b (TRAP-5b), as bone resorption markers, and osteocalcin (OC) and bone-specific alkaline phosphatase (b-ALP), as bone formation markers, were assessed. Seventy men with haemophilia A (n = 59) or B (n = 11) were studied. Patients with low BMD had significantly higher b-ALP concentrations compared with those with normal BMD (12.8 ± 1.60 vs. 9.72 ± 0.58 μg/L, P = 0.009), without any differences in the other BTM. NTX-I and CTX-I concentrations were negatively associated with oestradiol levels and hip BMD and positively with human immunodeficiency virus infection, number of affected joints and arthropathy scores. B-ALP and OC concentrations were negatively associated with hip BMD, severity of haemophilia and fracture history, and positively with the number of affected joints and testosterone concentrations. After multivariate analysis, NTX-I levels remained negatively associated with oestradiol levels, whereas b-ALP concentrations negatively correlated with the level of physical activity and positively with the number of affected joints. Increased bone metabolism exists in men with haemophilia and low BMD. Increased b-ALP levels may identify patients at high risk for fracture. Increased number of target joints, low physical activity and low oestradiol concentrations are independently associated with increased bone metabolism.
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Affiliation(s)
- P Anagnostis
- Haemophilia Centre of Northern Greece, Second Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece
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Sugiguchi S, Goto H, Inaba M, Nishizawa Y. Preferential reduction of bone mineral density at the femur reflects impairment of physical activity in patients with low-activity rheumatoid arthritis. Mod Rheumatol 2010; 20:69-73. [PMID: 19915945 DOI: 10.1007/s10165-009-0242-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2009] [Accepted: 09/25/2009] [Indexed: 11/24/2022]
Abstract
Bone mineral density (BMD) and factors influencing BMD in rheumatoid arthritis (RA) under good or moderate control were examined to assess management of osteoporosis in RA. BMD of the lumbar spine, femur, and distal radius was measured in 105 female patients with well-controlled RA. Laboratory and clinical variables associated with disease activity were measured in the same subjects, and correlations between these variables and BMD were evaluated. The RA patients showed a greater decrease in BMD of the femoral neck than of the lumbar spine. Age, Health Assessment Questionnaire (HAQ) score, and Larsen damage score had negative correlations with BMD of the femoral neck. In multiple regression analysis of the parameters associated with BMD of the femoral neck in simple regression analysis, an increase in HAQ score showed a negative correlation with BMD of the femoral neck. After initiation of treatment with alendronate (ALN), BMD of the femoral neck increased and correlated with improvement in HAQ score. A decrease in BMD of the femoral neck is a characteristic of RA. This suggests that muscle tonus has more effect than weight-bearing activity on BMD in patients with RA. BMD of the femoral neck is a useful index for general evaluation of RA patients.
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Affiliation(s)
- Shigeru Sugiguchi
- Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine, Osaka 545-8585, Japan
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Franck H, Braun J, Buttgereit F, Demary W, Hein G, Kekow J, Schett G, Kern PM. [Bone densitometry in inflammatory rheumatic diseases : Characteristics of the measurement site and disease-specific factors]. Z Rheumatol 2010; 68:845-50. [PMID: 19714343 DOI: 10.1007/s00393-009-0502-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Bone densitometry should be performed earlier in patients with inflammatory arthritis, since factors such as inflammation and drug therapy, in particular treatment with glucocorticoids, have an important impact on the development of osteoporosis. DXA (Dual energy X-ray Absorptiometry) is considered the gold standard for bone densitometry. According to the German guidelines for osteoporosis, bone densitometry plays a crucial role in the choice of therapy.In patients with rheumatoid arthritis, measurement of peripheral bone (forearm) density in addition to lumbar spine and hip is recommended, since local bone loss is pathognomonic for this disease. DXA measurements of the hand enable the diagnosis of juxtaarticular osteoporosis at an earlier stage; however, this has not yet been established in routine practise.Bone measurement in patients with ankylosing spondylitis can be performed in the lumbar spine and the hip at disease onset. In systemic lupus erythematosus, bone loss is more frequent in patients with high inflammatory activity. Patients with psoriasis arthritis frequently have osteoporosis in the case of a destructive development of the joints.
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Affiliation(s)
- H Franck
- Schwerpunktpraxis Rheumatologie, Godesberger Allee 90, 53175, Bonn, Deutschland.
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Guler H, Turhanoglu AD, Ozer B, Ozer C, Balci A. The relationship between anti‐cyclic citrullinated peptide and bone mineral density and radiographic damage in patients with rheumatoid arthritis. Scand J Rheumatol 2009; 37:337-42. [DOI: 10.1080/03009740801998812] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Tateiwa T, Shinmura K, Ko M, Mibe J, Yamamoto K. Iliopectineal bursitis associated with rapid destruction of a rheumatoid hip joint. J Orthop Sci 2009; 14:455-8. [PMID: 19662482 DOI: 10.1007/s00776-009-1354-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2008] [Accepted: 02/06/2009] [Indexed: 11/28/2022]
Affiliation(s)
- Toshiyuki Tateiwa
- Department of Orthopedic Surgery, Tokyo Metropolitan Ohtsuka Hospital, Minami-ohtsuka, Toshima-ku, Tokyo, Japan
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Peripheral bone density in patients with rheumatoid arthritis. Clin Rheumatol 2009; 28:1141-5. [DOI: 10.1007/s10067-009-1211-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2009] [Revised: 05/17/2009] [Accepted: 05/30/2009] [Indexed: 10/20/2022]
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Lund Håheim L, Nafstad P, Olsen I, Schwarze P, Rønningen KS. C-reactive protein variations for different chronic somatic disorders. Scand J Public Health 2009; 37:640-6. [PMID: 19372230 DOI: 10.1177/1403494809104358] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AIMS To compare the levels of C-reactive protein (CRP) in a range of chronic disorders such as osteoporosis, asthma, diabetes, chronic bronchitis/emphysema, myocardial infarction, current oral infections, stroke, angina pectoris, hay fever, and fibromyalgia/chronic pain syndrome. METHODS In all, 5,323 men took part in the first and second health screening of the Oslo Study in 1972/73 and 2000. Questionnaire information on medical history recorded at the second screening was used to identify men with relevant diseases. Serum samples collected in 2000 were stored for later analyses of CRP. In 2000 the men were aged 48-77 years. RESULTS Men with self-reported myocardial infarction, asthma, diabetes, chronic bronchitis/ emphysema, osteoporosis or fibromyalgia/chronic pain syndrome had significantly elevated mean levels of CRP versus non-cases. Men with osteoporosis had the highest mean values of 6.53 versus 3.55 mg/l in participants without this disease. Cases of asthma also had an increased mean CRP level of 5.01 versus 3.47 mg/l in non-cases and in chronic bronchitis/emphysema the corresponding levels were 4.42 versus 3.59 mg/l. Men with diabetes had 4.53 versus 3.53 mg/l and men with myocardial infarction had 4.27 versus 3.59 mg/l. In fibromyalgia/chronic pain syndrome the values were 4.79 mg/l and 3.60 mg/l respectively. CONCLUSIONS Elevated CRP levels were observed in elderly men in a number of chronic diseases, indicating a persistent inflammatory response. Mean levels varied according to the disease and indicated a baseline level in the individuals with a particular disorder. This is useful knowledge when CRP is used in the clinic for infection and inflammation status.
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Wisłowska M, Jakubicz D, Stępień K, Cicha M. Serum concentrations of formation (PINP) and resorption (Ctx) bone turnover markers in rheumatoid arthritis. Rheumatol Int 2009; 29:1403-9. [DOI: 10.1007/s00296-009-0867-x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2008] [Accepted: 01/14/2009] [Indexed: 11/29/2022]
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Associations with subregional BMD-measurements in patients with rheumatoid arthritis. Rheumatol Int 2008; 29:47-51. [PMID: 18597090 DOI: 10.1007/s00296-008-0638-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2008] [Accepted: 06/15/2008] [Indexed: 02/06/2023]
Abstract
Patients with rheumatoid arthritis (RA) have bone loss to various degrees at different skeletal sites. The subregional bone mineral density (BMD) of the hand and the correlation of BMD to other regional bone losses, parameters of inflammation or bone resorption was evaluated in 421 patients with RA and controls. RA patients had significantly (P<0.01) lower BMD values in the carpus (0.405+/-0.004 g/cm2), metacarpal joint II (0.318+/-0.036 g/cm2) and metacarpal joint III (0.326+/-0.022 g/cm2) compared to controls. There was no difference in bone density at the lumbar spine or hip. Significant (P<0.001) correlations were found between BMD total of the hand, its subregions, the forearm and hip. Parameters of inflammation correlated significantly (P<0.001) with pyridinolines (r=0.378), desoxypyridinolines (r=0.183), forearm (r=-10, P<0.05), MCP II (r=-0.190, P<0.001), MCP III (r=0.204, P<0.001) and carpus (r=0.191, P<0.001).
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Mochizuki T, Momohara S, Ikari K, Kawamura K, Tsukahara S, Iwamoto T, Kobayashi S, Okamoto H, Nishimoto K, Tomatsu T. Spontaneous multiple insufficiency fractures after pelvic abscess and sepsis in a rheumatoid arthritis patient treated with high-load corticosteroid therapy: a case report. Clin Rheumatol 2007; 26:1925-8. [PMID: 17235652 DOI: 10.1007/s10067-007-0535-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2006] [Revised: 12/16/2006] [Accepted: 01/03/2007] [Indexed: 10/23/2022]
Abstract
We report the unique occurrence and treatment of spontaneous multiple insufficiency fractures after sepsis in a patient with rheumatoid arthritis (RA). The patient was a 53-year-old woman with a 13-year history of RA. Her disease activity was not influenced by a disease-modifying antirheumatic drug (DMARD) regimen that included bucillamine, D-penicillamine, gold, sulfasalazine, and methotrexate. Due to an increased disease activity, her DMARD treatment regimen was changed to leflunomide. She had also undergone corticosteroid therapy with prednisolone ranging from 10 to 15 mg daily over the previous 8 years. She first presented with a wound infection at the surgical site of resection arthroplasty on her left foot, which had caused hematogenous dissemination that led to pelvic abscess and sepsis. For the next 2 years, she experienced multiple insufficiency fractures in parts of the ilium, sacral body, sacral ala, three thoraco-lumbar vertebral bodies (T12, L1, and L2), and subcapital femoral neck without low energy trauma. Postmenopausal osteoporosis, pelvic abscess, sepsis, decreasing daily activity, high RA disease activity, and high-load corticosteroid therapy were considered to be the causes of these fractures. Nonspecific symptoms such as low back pain and fever delayed diagnosis, which may have led to secondary fractures. Although her course after treatment was satisfactory during the study period, we recommend taking repetitive radiographs to detect insufficiency fracture for RA patients with continuing pain and reducing the corticosteroid dose to prevent infection and fracture.
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Affiliation(s)
- Takeshi Mochizuki
- Institute of Rheumatology, Tokyo Women's Medical University, 10-22 Kawada, Shinjuku, Tokyo, 162-0054, Japan
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Yoshino K, Momohara S, Ikari K, Kawamura K, Mochizuki T, Iwamoto T, Niki Y, Saitou S, Tomatsu T. Acute destruction of the hip joints and rapid resorption of femoral head in patients with rheumatoid arthritis. Mod Rheumatol 2006; 16:395-400. [PMID: 17165003 DOI: 10.1007/s10165-006-0516-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2006] [Accepted: 08/01/2006] [Indexed: 10/23/2022]
Abstract
We report three rheumatoid arthritis (RA) cases with acute destruction of hip joint and rapid resorption of femoral head. The condition occurred in less than 6 months and closely resembled rapid destructive coxarthrosis. All three patients were postmenopausal women with active RA who had been taking steroids. Two of the patients were taking prednisolone (PSL) of over 20 mg as maximum dose per day, and all patients were resistant to disease-modifying anti-rheumatic drugs (DMARDs). Other than the problems of their hip joints, one had a giant bursitis around the pathological side of the hip joint, another had multiple rheumatoid nodules and skin infarction, and the other suffered from insufficiency fracture of the contralateral femoral subcapital lesion. As a result, all of them had total hip arthroplasty. We recommend taking repetitive radiographs for RA patients with continuing severe hip pain.
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Affiliation(s)
- Koichiro Yoshino
- Department of Orthopedic Surgery, Institute of Rheumatology, Tokyo Women's Medical University, 10-22 Kawada, Shinjuku, Tokyo 162-0054, Japan
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