Sandra Hermann, Andriko Palmowski, Kay Geert A Hermann, Burkhard Muche, Nadége Léprêtre, Tobias Alexander, Zhivana Boyadzhieva, Gerhard Krönke, Paula Hoff, Edgar Wiebe, Frank Buttgereit
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引用次数: 0
Abstract
Introduction: The role of uric acid (UA) on bone metabolism is controversially discussed. Higher UA levels have been associated with higher T-scores and a reduced incidence of fractures in postmenopausal women. However, in the context of rheumatoid arthritis (RA), the role of UA remains unclear. This pilot study aimed to investigate the association of UA levels with bone mineral density in RA female and male patients.
Methods: This pilot study analyzed patients with RA to explore preliminary associations. We utilized data from the Rh-GIOP cohort, a prospective monocentric observational study focusing on bone health in chronic rheumatic diseases. To assess the association between UA levels and the lowest T-scores measured at the lumbar spine, hip, or femur, we used linear regression with adjustment for various confounders. An interaction term was included to evaluate differential associations in pre- and postmenopausal women.
Results: Data on dual X-ray absorptiometry (DXA) measurements and serum UA levels were analyzed in a total of 206 patients. Among the 167 women 16 were premenopausal (age 40 ± 8 years) and 149 postmenopausal (age 65 ± 10 years). As expected, postmenopausal had lower T-scores than premenopausal patients (-1.53 ± 1.01 versus - 0.41 ± 1.29, respectively). No association of UA levels with T-scores was found when analyzing the whole cohort (Slope β: -0.04; p = 0.45). However, a significant negative correlation of UA with T-scores in premenopausal (Slope β: -0.98; p = 0.014), but not postmenopausal (Slope β: -0.04; p > 0.05) women was found.
Conclusion: Uric acid appears to be negatively associated with bone mineral density in premenopausal but not in postmenopausal women with RA. Thus, the impact of UA on bone health seems to depend on the hormonal status of women. Further investigations are required to validate these results in a larger cohort of patients and to investigate the underlying mechanisms.
导言：尿酸（UA）对骨代谢的作用一直备受争议。尿酸水平越高，绝经后妇女的 T 值越高，骨折发生率越低。然而，在类风湿性关节炎（RA）中，尿酸的作用仍不明确。这项试验性研究旨在调查类风湿性关节炎女性和男性患者体内尿酸水平与骨矿物质密度的关系：这项试验性研究分析了 RA 患者，以探索初步的关联。我们利用了Rh-GIOP队列的数据，该队列是一项前瞻性单中心观察研究，重点关注慢性风湿性疾病患者的骨健康状况。为了评估 UA 水平与腰椎、髋部或股骨测量的最低 T 值之间的关联，我们使用了线性回归，并对各种混杂因素进行了调整。为了评估绝经前和绝经后妇女的不同关联，我们加入了一个交互项：共对 206 名患者的双 X 射线吸收测量（DXA）测量数据和血清 UA 水平进行了分析。在这 167 名妇女中，16 人绝经前（40 ± 8 岁），149 人绝经后（65 ± 10 岁）。不出所料，绝经后患者的 T 值低于绝经前患者（分别为-1.53 ± 1.01 和 - 0.41 ± 1.29）。在分析整个队列时，未发现 UA 水平与 T 值有任何关联（斜率 β：-0.04；p = 0.45）。然而，在绝经前（斜率 β：-0.98；p = 0.014）而非绝经后（斜率 β：-0.04；p > 0.05）的妇女中，发现尿酸与 T 值呈明显的负相关：结论：尿酸似乎与绝经前 RA 妇女的骨矿物质密度呈负相关，但与绝经后 RA 妇女的骨矿物质密度无关。因此，尿酸对骨骼健康的影响似乎取决于女性的荷尔蒙状况。要在更大的患者群体中验证这些结果并研究其潜在机制，还需要进一步的研究。
期刊介绍：
RHEUMATOLOGY INTERNATIONAL is an independent journal reflecting world-wide progress in the research, diagnosis and treatment of the various rheumatic diseases. It is designed to serve researchers and clinicians in the field of rheumatology.
RHEUMATOLOGY INTERNATIONAL will cover all modern trends in clinical research as well as in the management of rheumatic diseases. Special emphasis will be given to public health issues related to rheumatic diseases, applying rheumatology research to clinical practice, epidemiology of rheumatic diseases, diagnostic tests for rheumatic diseases, patient reported outcomes (PROs) in rheumatology and evidence on education of rheumatology. Contributions to these topics will appear in the form of original publications, short communications, editorials, and reviews. "Letters to the editor" will be welcome as an enhancement to discussion. Basic science research, including in vitro or animal studies, is discouraged to submit, as we will only review studies on humans with an epidemological or clinical perspective. Case reports without a proper review of the literatura (Case-based Reviews) will not be published. Every effort will be made to ensure speed of publication while maintaining a high standard of contents and production.
Manuscripts submitted for publication must contain a statement to the effect that all human studies have been reviewed by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in an appropriate version of the 1964 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted.
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