Delgado-Frías Esmerald, López-Mejias Raquel, Genre Fernanda, Ubilla Begoña, Gómez Rodríguez-Bethencourt María A, González-Díaz Antonieta, de Vera-González Antonia M, González-Rivero Agustín F, Díaz-González Federico, González-Gay Miguel A, Ferraz-Amaro Iván
Division of Rheumatology, Hospital Universitario de Canarias, Tenerife, Spain.
Division of Rheumatology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain.
Clin Exp Rheumatol. 2015 Mar-Apr;33(2):241-9. Epub 2015 Mar 10.
We aimed to investigate whether the abnormalities in bone mineral density (BMD) that occur in patients with rheumatoid arthritis (RA) are associated with the presence of endothelial dysfunction.
Cross-sectional study encompassing 216 subjects (111 patients with RA and 105 age- and sex-matched controls) without history of cardiovascular disease. Endothelial function was determined by brachial artery flow-mediated dilatation (FMD) and BMD by dual x-ray absorptiometry (DXA) measurements. Plasma vitamin D and osteoprotegerin serum (OPG) levels were assessed in patients and controls. Multiple regression analysis was performed to study the relationship between BMD with endothelial function, taking into account vitamin D and OPG levels.
After adjusting for traditional cardiovascular risk factors, vitamin D and OPG levels, BMD emerged as an independent factor associated with lower FMD values in controls, but not in patients with RA. Although OPG levels were inversely associated with FMD values in both RA patients and controls after adjusting for BMD, vitamin D showed this relationship only in the controls.
Whilst OPG is associated with endothelial function in RA patients and controls, vitamin D levels and BMD are related to endothelial function in controls but not in patients with RA.
我们旨在研究类风湿关节炎（RA）患者出现的骨密度（BMD）异常是否与内皮功能障碍的存在相关。
对216名无心血管疾病史的受试者（111名RA患者和105名年龄及性别匹配的对照者）进行横断面研究。通过肱动脉血流介导的血管舒张（FMD）测定内皮功能，通过双能X线吸收法（DXA）测量BMD。对患者和对照者评估血浆维生素D和骨保护素血清（OPG）水平。进行多元回归分析以研究BMD与内皮功能之间的关系，同时考虑维生素D和OPG水平。
在调整传统心血管危险因素、维生素D和OPG水平后，BMD成为与对照者较低FMD值相关的独立因素，但在RA患者中并非如此。尽管在调整BMD后，OPG水平在RA患者和对照者中均与FMD值呈负相关，但维生素D仅在对照者中显示出这种关系。
虽然OPG在RA患者和对照者中均与内皮功能相关，但维生素D水平和BMD与对照者的内皮功能相关，而与RA患者的内皮功能无关。
