Grisar Johannes, Bernecker Peter M, Aringer Martin, Redlich Kurt, Sedlak Markus, Wolozcszuk Wolfgang, Spitzauer Susanne, Grampp Stephan, Kainberger Franz, Ebner Wolfgang, Smolen Josef S, Pietschmann Peter
Department of Internal Medicine III, University of Vienna, Austria.
J Rheumatol. 2002 Jul;29(7):1430-6.
To test if markers of bone metabolism are altered in patients with seronegative spondyloarthropathies (SSpA).
We studied biochemical markers of bone resorption and bone formation, osteoprotegerin (OPG), and bone mineral density (BMD) in patients with psoriatic arthritis (PsA), ankylosing spondylitis (AS), and reactive arthritis (ReA) and healthy volunteers.
The bone resorption markers urinary deoxypyridinoline and crosslinked telopeptide of collagen-I were significantly increased in patients with AS, PsA, and ReA; in PsA they correlated with the acute phase response (C-reactive protein and erythrocyte sedimentation rate). The bone formation markers were divergent: bone-specific alkaline phosphatase was increased in PsA, but not in AS or ReA. Osteocalcin levels were only elevated in AS. Serum levels of OPG were significantly increased in both AS and PsA. Dual energy x-ray absorptiometry (DEXA) measurements of lumbar spine and femoral neck revealed osteopenia in patients with AS, whereas the DEXA distribution was within normal range in PsA.
Our data indicate high and, particularly in AS, unbalanced bone turnover in SSpA, consistent with the decrease in BMD found in patients with AS.
检测血清阴性脊柱关节病（SSpA）患者的骨代谢标志物是否发生改变。
我们研究了银屑病关节炎（PsA）、强直性脊柱炎（AS）、反应性关节炎（ReA）患者及健康志愿者的骨吸收和骨形成生化标志物、骨保护素（OPG）及骨密度（BMD）。
AS、PsA和ReA患者的骨吸收标志物尿脱氧吡啶啉和I型胶原交联端肽显著升高；在PsA中，它们与急性期反应（C反应蛋白和红细胞沉降率）相关。骨形成标志物则有所不同：骨特异性碱性磷酸酶在PsA中升高，但在AS或ReA中未升高。骨钙素水平仅在AS中升高。AS和PsA患者的血清OPG水平均显著升高。腰椎和股骨颈的双能X线吸收法（DEXA）测量显示，AS患者存在骨质减少，而PsA患者的DEXA分布在正常范围内。
我们的数据表明，SSpA患者存在高骨转换，尤其是AS患者骨转换失衡，这与AS患者BMD降低一致。
