Abstract
Generalized bone loss is recognized as a major event in RA. Both biochemical parameters of bone metabolism and the bone mineral density were investigated in remission, non-steroid treated patients with RA in order to assess bone turnover and bone loss in remission phase RA.
We studied 31 patients of remission RA with good response to DMARDs and compared with remission SLE and normal young adults. Urinary NTx, pyridinoline (PYR), deoxypyridinoline (DPYR) and TRAP, as parameters of bone resorption and serum bone related alkaline phosphatase (ALP III), osteocalcine and ICP (S) were measured in RA, SLE and healthy subjects. Total bone density (TBD), trabecular density (TD) and cortex density (CD) were also evaluated using XCT960 pQCT.
ALP III, osteocalcine and ICP (S) levels were significantly lower in RA compared with 6 healthy subjects, but there was no significant difference between SLE and healthy subjects.
PYR levels were elevated in stage III and IV of RA but were similar between SLE and healthy subjects. TBD including TD and CD was significantly reduced in RA patients compared with the control group. Decreasing ratio of TBD in RA patients was correlated with advancement of RA. However, TBD value in stage IV RA patients were seemingly increased as compression fracture of lumber spine in osteoporosis.
These results suggest that bone metabolism may be uncouple in remission phase RA. Bone formation appeared to be reduced, whereas resorption is increased.
