抗瓜氨酸多肽抗体对类风湿关节炎患者骨密度降低和发生重大骨质疏松性骨折的影响:回顾性病例对照研究

Q4 Medicine Clinical Osteology Pub Date : 2023-04-06 DOI:10.3390/osteology3020006
I. Yoshii, T. Chijiwa, N. Sawada
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引用次数: 0

摘要

背景:采用回顾性纵向病例对照研究,评价抗瓜氨酸化多肽抗体(ACPA)对类风湿关节炎(RA)患者骨密度(BMD)降低和严重骨质疏松性骨折(MOF)发生率的影响。方法:招募双能x线吸收仪检查并同时治疗5年以上的RA患者。评估初始测量时的BMD绝对值和z评分(基线)以及这些值与基线的变化,并统计评估BMD与候选危险因素(包括ACPA阳性和血清滴度水平)之间的相关性。对ACPA阳性与MOF发病率的关系进行了进一步的统计评估。结果:共纳入222例患者。使用多变量模型,高ACPA滴度与基线时较低的BMD和z评分显著相关(p < 0.05)。在单变量模型中,ACPA阳性与随访时全髋关节z评分的低值和年度下降显著相关(p < 0.05),而在多变量模型中,没有发现显著相关性。acpa阳性组z -score显著低于acpa阴性组(p < 0.05)。然而,acpa阳性患者发生MOF的风险并不高。结论:ACPA的存在是一种潜在的BMD损失风险,尽管这种风险很小。
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The Influence of Anti-Citrullinated Polypeptide Antibodies on Bone Mineral Density Decrease and Incident Major Osteoporotic Fractures in Patients with Rheumatoid Arthritis: A Retrospective Case-Control Study
Background: Effects of anti-citrullinated polypeptide antibodies (ACPA) on the bone mineral density (BMD) reduction and incidence of major osteoporotic fractures (MOF) in patients with rheumatoid arthritis (RA) were evaluated using a retrospective longitudinal case-control study. Methods: Patients with RA who were examined using dual-energy X-ray absorptiometry and simultaneously treated for more than 5 years were recruited. BMD absolute value and Z-scores at initial measurements (baseline) and changes of these values from baseline were assessed, and associations between BMD and candidate risk factors including ACPA positivity and serum titer levels were statistically evaluated. Additional statistical evaluations of ACPA positivity in regard to the incidence of MOF were tested. Results: A total of 222 patients were included. Higher ACPA titers correlated significantly with lower BMD and Z-scores at baseline using a multivariate model (p < 0.05). ACPA positivity correlated significantly with lower values and an annual decrease in the Z-score in total hip at follow-up using a univariate model (p < 0.05), whereas no significant correlation was found using a multivariate model. Z-scores in the ACPA-positive group were significantly lower than those of the ACPA-negative group (p < 0.05). However, ACPA-positivity demonstrated no higher risk for incident MOF. Conclusions: The presence of ACPA is a potential risk of BMD loss however weak.
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Clinical Osteology
Clinical Osteology Medicine-Endocrinology, Diabetes and Metabolism
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