The Clinical Significance Of Bone Metabolism Markers And Bone Mineral Density Of Rheumatoid Arthirtis

Objective To investigate the change and clinical significance of bone metabolismmarkers, bone mineral density (BMD) and bone mineral content (BMC) of patients withrheumatoid arthritis (RA).Methods Choose71cases of RA patients (RA group) and20cases of normal(control group). The level of BGP, CTX in serum were measured by ELISA.The Bonemineral density (BMD) and bone mineral content (BMC) of patients were measured bymeans of dual energy x-ray absorptiometry (DEXA) in the forearm. The level of ESR inserum was measured by Wilcoxon. The level of CRP in serum was measured byimmunoturbidimetric, the level of RF in serum was measured by the rate nephelometrymethod. The level of Anti-CCP in serum was measured by ELISA. The correlations ofindexes were analyzed by linear correlation analysis and multiple linear regressionanalysis.Results The CTX and BGP of patients with RA were significant higher compared tonormal control group (P<0.05). The BMD and the BMC of patients with RA weresignificant deceased compared to normal control group (P<0.05). The CTX of X-ray IIIphase was higher than I, II X-ray phase. The rectilinear correlation analysis showed thatthe CTX with the BMD, BMC in forearm were negatively correlated (r=-0.301, p=0.014;r=-0.296, p=0.015),and positive with pathogenesis and age （r=0.382,p=0.001；r=0.263,p=0.029）.Respectively, the BMD in forearm was negatively correlated withDAS28score, ESR and RF, pathogenesis and age (r=-0.357,-0.390,-0.255,-0.402,-0.337,P<0.01). There was a significant negative correlation between BMC inforearm and DAS28score, ESR and CRP (r=-0.344,-0.401,-0.283, P<0.05). And multiple linear regression analysis showed that the BMD in forearm of RA werenegatively correlated with RF and age; The BMC in forearm was negatively correlatedwith the DAS score. The patients of RA with X-ray for the period I have19people,which six patients showed osteoporosis, bone mass decreased by five people, bone lossand osteoporosis in patients with a total of eleven (57.89%). The Spearman correlationanalysis showed that the BMD, BMC were negatively correlated with the X-ray, theCTX of RA were positive correlated with X-ray.Conclusion1.The bone resorption indices,and bone formation index of RA group thanthe normal control group were significantly increased, suggesting that the RA patientswith osteoporosis for high conversion type, bone metabolic markers can detcet bonedestruction of RA patients.2. The BMD and the BMC of patients with RA were significant deceased compared tonormal control group, The BMD can provide the basis for the diagnosis of bonedestruction in RA patients.3. The BMD and BMC were negatively correlated with DAS28, ESR in patients withRA, respectively, which suggested that bone mineral density and bone mineral loss maybe closely related with disease activity.4. The CTX of RA was positively correlated with RF,the BMD and BMC in forearm ofRA were negatively correlated with RF, witch suggested that RF may be a risk factor forRA patients bone damage.