Departamento de Fisiología, Instituto de Investigación en Ciencias Biomédicas, Programa de Doctorado en Salud Publica, Departamento de Salud Publica, Programa de Doctorado en Farmacología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco, México.
Unidad de Investigación Biomédica 02, UMAE, Hospital de Especialidades, Centro Médico Nacional de Occidente (CMNO), Instituto Mexicano del Seguro Social (IMSS), Guadalajara, Jalisco, México.
Medicine (Baltimore). 2022 Feb 11;101(6):e28799. doi: 10.1097/MD.0000000000028799.
Irisin stimulates osteoblast differentiation increasing bone mass a decreasing in irisin levels might contribute to osteoporotic fractures in inflammatory diseases. To date, there is controverted whether irisin levels are associated with osteoporotic fractures in rheumatoid arthritis (RA). Therefore, we evaluate the association of serum irisin with osteoporotic Vertebral Fractures (VFs) in women with RA.A total of 148 women with RA was included in the study.Clinical characteristics and risk factors of VFs was evaluated. For measurement of bone mineral density we included the assessment of lumbar spine (AP L1-L4) and Femoral Neck by dual-energy X-ray absorptiometry (DXA). VFs were evaluated by lateral vertebral assessment (LVA) of the dorsal and lumbar regions using X-ray and digital vertebral morphometry by DXA, using the Genant scale. Serum irisin levels were measured by ELISA. A reference group of 97 women with non-rheumatic diseases were included to compare irisin levels.RA patients had a median age of 59 years and 41% had osteoporosis. Seventy three (49%) had VFs. Lower irisin levels were observed in RA patients compared to controls (94 ± 74 vs 135 ± 103, P < .001). Irisin concentrations were lower in RA + VFs than RA non-VFs (74 ± 42 vs 113 ± 92 ng/mL, P = .001). In the multivariable logistic regression analysis the low 50 percentile irisin levels < 73 ng/mL (OR:3.1, 95% CI:1.55-6.2, P = .001), and disease duration of RA (OR:1.04, 95% CI:1.001-1.08, P = .04) were associated with an increase in the risk of VFs.A decrease of irisin levels is associated to VFs in RA. These results are valuable to consider that RA patients with low levels of irisin are in a potential risk of VFs.
鸢尾素可刺激成骨细胞分化，增加骨量，而鸢尾素水平降低可能导致炎症性疾病中的骨质疏松性骨折。迄今为止，关于鸢尾素水平与类风湿关节炎（RA）中的骨质疏松性骨折是否相关仍存在争议。因此，我们评估了血清鸢尾素与女性 RA 患者骨质疏松性椎体骨折（VFs）的相关性。
共纳入 148 例 RA 女性患者。评估了 VFs 的临床特征和危险因素。为了测量骨密度，我们通过双能 X 射线吸收法（DXA）评估了腰椎（AP L1-L4）和股骨颈。通过 X 射线侧位评估（LVA）和 DXA 的数字椎体形态计量学，使用 Genant 量表评估 VFs。通过 ELISA 测量血清鸢尾素水平。纳入 97 例非风湿性疾病的参考组以比较鸢尾素水平。
RA 患者的中位年龄为 59 岁，41%患有骨质疏松症。73 例（49%）发生 VFs。与对照组相比，RA 患者的鸢尾素水平较低（94±74 比 135±103，P<0.001）。RA+VFs 患者的鸢尾素浓度低于 RA 非 VFs 患者（74±42 比 113±92ng/ml，P=0.001）。多变量逻辑回归分析显示，低 50 分位数鸢尾素水平<73ng/ml（OR：3.1，95%CI：1.55-6.2，P=0.001）和 RA 病程（OR：1.04，95%CI：1.001-1.08，P=0.04）与 VFs 风险增加相关。
鸢尾素水平降低与 RA 中的 VFs 相关。这些结果表明，鸢尾素水平较低的 RA 患者可能存在 VFs 的潜在风险。
