Department of Rheumatology and Applied Immunology, Faculty of Medicine, Saitama Medical University, 38 Morohongo, Moroyama-machi, Iruma-gun, Saitama 350-0495, Japan.
Mod Rheumatol. 2013 Mar;23(2):269-75. doi: 10.1007/s10165-012-0654-5. Epub 2012 May 15.
Osteoprotegerin (OPG), a regulator of bone resorption, is involved in the pathogenesis of rheumatoid arthritis (RA) and atherosclerosis. OPG is elevated in patients with coronary artery disease, and high OPG levels are associated with cardiac disease severity and mortality in the general population. The purpose of this study was to investigate the relationship of serum OPG levels, traditional coronary risk factors, and RA-related factors to carotid atherosclerosis in RA patients.
Ninety-one RA patients were studied (85 % women, age 60 ± 10 years). Serum OPG levels were measured by an enzyme-linked immunosorbent assay. The prevalence of carotid plaque was assessed by ultrasonographic imaging in all patients. The relationship between various clinical characteristics, OPG, and carotid plaque was examined.
Serum OPG levels were significantly higher in patients with carotid plaque than in those without plaque (median level 1,397 vs. 887 pg/mL, respectively; P = 0.006). There were no significant differences between RA patients with and without carotid plaque with respect to sex, duration of RA, blood pressure, body mass index, smoking, low-density lipoprotein cholesterol, Disease Activity Score-28, van der Heijde-modified Sharp score, and prednisolone dose. After adjusting for age, sex, and C-reactive protein, elevated levels of OPG were still associated with a higher prevalence of carotid plaque in patients with RA (P = 0.038).
RA patients suffer from accelerated atherosclerosis and also have increased levels of OPG. The serum OPG level is independently associated with carotid plaque.
骨保护素（OPG）是一种骨吸收的调节剂，参与类风湿关节炎（RA）和动脉粥样硬化的发病机制。在冠心病患者中，OPG 水平升高，而高水平的 OPG 与普通人群中心脏病的严重程度和死亡率相关。本研究的目的是探讨 RA 患者血清 OPG 水平、传统冠心病危险因素和与 RA 相关的因素与颈动脉粥样硬化之间的关系。
研究了 91 例 RA 患者（85%为女性，年龄 60±10 岁）。采用酶联免疫吸附试验测定血清 OPG 水平。所有患者均行超声影像学检查评估颈动脉斑块的发生情况。检查了各种临床特征、OPG 和颈动脉斑块之间的关系。
颈动脉斑块患者的血清 OPG 水平明显高于无斑块患者（中位数水平分别为 1397pg/ml 和 887pg/ml，P=0.006）。颈动脉斑块阳性和阴性的 RA 患者在性别、RA 病程、血压、体重指数、吸烟、低密度脂蛋白胆固醇、疾病活动评分-28、van der Heijde 改良 Sharp 评分和泼尼松龙剂量方面均无显著差异。在校正年龄、性别和 C 反应蛋白后，OPG 水平升高仍与 RA 患者颈动脉斑块的发生呈正相关（P=0.038）。
RA 患者患有加速的动脉粥样硬化，并且 OPG 水平也升高。血清 OPG 水平与颈动脉斑块独立相关。
