ABSTRACT
Rheumatoid arthritis [RA] is a chronic inflammatory disease, with symmetric polyarthritis. There are two types of osteoporosis [OP] associated with RA; periarticular and systemic. Generalized OP in RA patients is believed to be associated with increased production of inflammatory cytokines. The aim of the present work is to evaluate the bone mineral density [BMD] and the frequency of reduced bone mass in RA patients. The influence of different variables related to the patient, the disease and the medications on BMD in RA patients were also assessed. This study was conducted on 100 adult RA patients [88 females and 12 males] and 100 healthy age and sex matched controls. The mean age of patients and controls were 36.11 +/- 9.279 and 35.87 +/- 9.32 years, respectively. The mean disease duration was 5.46 +/- 5.366 years. All the patients were subjected to full history taking, full general and locomotor examination and laboratory investigations. Bone densitometry was performed by dual X-ray absorptiometry equipment in the lumbar spine [LS] femoral neck [FN] and distal third of radius. Two RA groups were analyzed, patients receiving corticosteroids [n= 19] and patients not receiving corticosteroids [n= 81]. At the LS 36% of patients had osteopenia and 9% had osteoporosis compared to 1% of controls had osteopenia [P=0.001], At FN 28% of patients had osteopenia and 3% had osteoporosis while all controls were normal [P=0.001], at radius 24% of patients had osteopenia and 13% had osteoporosis and all the controls were normal [P<0.001]. Considering disease activity, our study showed that DAS 28 is a significant predictor of low BMD by using multilinear regression analysis in both hip [P = 0.049] and radius [P = 0.022], also by Pearson correlation, DAS 28 was found to have negative correlation with BMD at radius [P= 0.023 r = -0.228]. Mean BMD showed no significant differences among corticosteroid users and non users at LS, FN and the radius.[P =0.644, 0.107 and 0.401 respectively], however, cumulative dose of corticosteroids showed significant negative correlation with BMD at hip [P= 0.039 r= - 0.206]. Body mass index [BMI] showed a positive statistically significant correlation with BMD at lumbar spine [r-0.265; P = 0.008] the hip [r- 0.362; P = 0.000] and distal third of radius [r = 0.250; P = 0.012]. There is increased frequency of reduced BMD in RA patients indicating that disease related factors [Rheumatoid factor and Disease activity score DAS 28], as well as patients related factors [age, BMI] and cumulative dose of corticosteroids were found to be associated with the reduction of BMD
Subject(s)
Humans , Male , Female , Bone Density , Absorptiometry, Photon/methods , Body Mass Index , OsteoporosisABSTRACT
The aim of the study is to investigate the incidence and clinical significance of Anti-CCP antibodies in Juvenile Idiopathic Arthritis [JIA] patients assessing its utility as a serological marker and its relationship with disease subtype and erosive form of the disease. This study comprised twenty-five [17 girls, 8 boys] patients with JIA attending the Rheumatology and Rehabilitation Department in Kasr El-Aini hospitals as well as New children Hospital, Faculty of Medicine, Cairo University. Ten healthy volunteers served as controls. RF positivity was observed only in 9 children with JIA and 7 patients had persistent erosive lesions in their joints. Anti-CCP antibody levels were determined by ELISA and values above 5 relative units [RU] were regarded as positive. Anti-CCP antibodies were found in 10/25 [40%] patients including 8/9 RF positive polyarthritis [88.9% of this subset], 1/2 RF negative polyarthritis, 1/8 pauciarticular arthritis and 0/6 systemic arthritis [p value