Guler H, Turhanoglu A D, Ozer B, Ozer C, Balci A
Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Mustafa Kemal University, Hatay, Turkey.
Scand J Rheumatol. 2008 Sep-Oct;37(5):337-42. doi: 10.1080/03009740801998812.
We aimed to investigate the relationship between anti-cyclic citrullinated peptide (anti-CCP) levels and bone mineral density (BMD), bone turnover, and radiographic damage in patients with rheumatoid arthritis (RA).
Eighty patients (68 females, 12 males, mean age 46.50+/-14.59 years) with RA were included in the study. Anti-CCP antibodies were measured by enzyme-linked immunosorbent assay (ELISA). Bone turnover was studied by analysing serum levels of C-terminal telopeptide of type I collagen (sCTX, ng/mL), using an enzyme immunoassay. BMD was measured by dual-energy X-ray absorptiometry (DXA). Disease activity was assessed according to the Disease Activity Score that includes 28 joint counts (DAS28). Functional capacity was assessed by the Health Assessment Questionnaire (HAQ).
Anti-CCP-positive patients were defined as group 1 and anti-CCP-negative patients as group 2. The mean disease duration was 7.53+/-6.27 years in group 1 and 6.25+/-6.51 years in group 2. Anti-CCP had a limited negative correlation with lumbar BMD (r = -0.220, p = 0.050) and a negative correlation with femoral BMD (r = -0.242, p = 0.031). There was no statistically significant correlation between anti-CCP and sCTX values (r = 0.117, p = 0.301). Sharp scores were significantly higher in anti-CCP-positive than anti-CCP-negative patients (p = 0.012), and anti-CCP levels were significantly correlated with Sharp scores (r = 0.240, p = 0.032).
We found that RA patients with higher levels of anti-CCP antibody had lower lumbar and femoral BMD. Anti-CCP levels were also associated with radiographic damage. Therefore, we suggest that anti-CCP may be a determinant of bone loss in patients with RA.
我们旨在研究类风湿关节炎（RA）患者中抗环瓜氨酸肽（anti-CCP）水平与骨密度（BMD）、骨转换及影像学损伤之间的关系。
本研究纳入了80例RA患者（68例女性，12例男性，平均年龄46.50±14.59岁）。采用酶联免疫吸附测定（ELISA）法检测anti-CCP抗体。通过酶免疫测定法分析血清I型胶原C末端肽（sCTX，ng/mL）水平来研究骨转换。采用双能X线吸收法（DXA）测量BMD。根据包括28个关节计数的疾病活动评分（DAS28）评估疾病活动度。通过健康评估问卷（HAQ）评估功能能力。
anti-CCP阳性患者定义为第1组，anti-CCP阴性患者定义为第2组。第1组的平均病程为7.53±6.27年，第2组为6.25±6.51年。anti-CCP与腰椎BMD呈有限的负相关（r = -0.220，p = 0.050），与股骨BMD呈负相关（r = -0.242，p = 0.031）。anti-CCP与sCTX值之间无统计学显著相关性（r = 0.117，p = 0.301）。anti-CCP阳性患者的Sharp评分显著高于anti-CCP阴性患者（p = 0.012），且anti-CCP水平与Sharp评分显著相关（r = 0.240，p = 0.032）。
我们发现anti-CCP抗体水平较高的RA患者腰椎和股骨BMD较低。anti-CCP水平还与影像学损伤相关。因此，我们认为anti-CCP可能是RA患者骨质流失的一个决定因素。
