Hofbauer L C, Schoppet M, Christ M, Teichmann J, Lange U
Department of Internal Medicine, Philipps-University, Baldingerstrasse, D-35033 Marburg, Germany.
Rheumatology (Oxford). 2006 Oct;45(10):1218-22. doi: 10.1093/rheumatology/kel108. Epub 2006 Mar 30.
The degree of bone loss in patients with psoriatic arthritis (PsA) has not been well-defined. We tested the hypothesis, whether serum levels of tumour necrosis factor-related apoptosis-inducing ligand (TRAIL), a pro-apoptotic cytokine and osteoprotegerin (OPG), an anti-osteoclastic cytokine, are associated with changes in biochemical markers of bone turnover or bone mineral density (BMD) in patients with PsA.
In a cross-sectional study, we evaluated biochemical markers of bone turnover, BMD and serum levels of TRAIL and OPG in 116 patients with PsA (mean age: 52+/-13 yrs).
In patients with PsA, osteopenia was present in one-third of women and men, while osteoporosis was more frequent in men (10.2%) than in women (1.75%). Serum levels of TRAIL were significantly higher in patients with PsA (66.1+/-45.3 pmol/l) compared with controls (50.0+/-20.1 pmol/l, P<0.01), whereas OPG serum levels were not different. There were no associations between TRAIL or OPG serum levels with BMD and biochemical markers of bone turnover. However, TRAIL serum levels were associated with C-reactive protein (CRP) levels (R = 0.201, P<0.05), whereas OPG serum levels were associated with the erythrocyte sedimentation rate (R=0.215, P<0.05).
In summary, BMD is decreased in one-third of patients with PsA, and predominantly men with PsA suffer from osteoporosis. While TRAIL serum levels are increased in PsA and correlated with CRP levels, neither TRAIL nor OPG serum levels are correlated with BMD or markers of bone metabolism.
银屑病关节炎(PsA)患者的骨质流失程度尚未明确界定。我们检验了以下假设,即促凋亡细胞因子肿瘤坏死因子相关凋亡诱导配体(TRAIL)和抗破骨细胞细胞因子骨保护素(OPG)的血清水平是否与PsA患者骨转换生化标志物或骨密度(BMD)的变化相关。
在一项横断面研究中,我们评估了116例PsA患者(平均年龄:52±13岁)的骨转换生化标志物、BMD以及TRAIL和OPG的血清水平。
在PsA患者中,三分之一的女性和男性存在骨质减少,而男性骨质疏松症的发生率(10.2%)高于女性(1.75%)。与对照组(50.0±20.1 pmol/l,P<0.01)相比,PsA患者的TRAIL血清水平显著更高(66.1±45.3 pmol/l),而OPG血清水平无差异。TRAIL或OPG血清水平与BMD及骨转换生化标志物之间无关联。然而,TRAIL血清水平与C反应蛋白(CRP)水平相关(R = 0.201,P<0.05),而OPG血清水平与红细胞沉降率相关(R = 0.215,P<0.05)。
总之,三分之一的PsA患者骨密度降低,且主要是患有PsA的男性患骨质疏松症。虽然PsA患者的TRAIL血清水平升高且与CRP水平相关,但TRAIL和OPG血清水平均与BMD或骨代谢标志物无关。