Alterations of Bone Density, Microstructure, and Strength of the Distal Radius in Male Patients With Rheumatoid Arthritis: A Case-Control Study With HR-pQCT
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摘要In this cross-sectional study, we investigated volumetric bone mineral density (vBMD), bone microstructure, and biomechanical competence of the distal radius in male patients with rheumatoid arthritis (RA). The study cohort comprised 50 male RA patients of average age of 61.1 years and 50 age-matched healthy males. Areal BMD (aBMD) of the hip, lumbar spine, and distal radius was measured by dual-energy X-ray absorptiometry. High-resolution peripheral quantitative computed tomography (HR-pQCT) of the distal radius provided measures of cortical and trabecular vBMD, microstructure, and biomechanical indices. aBMD of the hip but not the lumbar spine or ultradistal radius was significantly lower in RA patients than controls after adjustment for body weight. Total, cortical, and trabecular vBMD at the distal radius were, on average, -3.9% to -23.2% significantly lower in RA patients, and these differences were not affected by adjustment for body weight, testosterone level, or aBMD at the ultradistal radius. Trabecular microstructure indices were, on average, -8.1% (trabecular number) to 28.7% (trabecular network inhomogeneity) significantly inferior, whereas cortical pore volume and cortical porosity index were, on average, 80.3% and 63.9%, respectively, significantly higher in RA patients. RA patients also had significantly lower whole-bone stiffness, modulus, and failure load, with lower and more unevenly distributed cortical and trabecular stress. Density and microstructure indices significantly correlated with disease activity, severity, and levels of pro-inflammatory cytokines (interleukin [IL] 12p70, tumor necrosis factor, IL-6 and IL-1 beta). Ten RA patients had focal periosteal bone apposition most prominent at the ulnovolar aspect of the distal radius. These patients had shorter disease duration and significantly higher cortical porosity. In conclusion, HR-pQCT reveals significant alterations of bone density, microstructure, and strength of the distal radius in male RA patients and provides new insight into the microstructural basis of bone fragility accompanying chronic inflammation. (C) 2014 American Society for Bone and Mineral Research.
著者Zhu TY, Griffith JF, Qin L, Hung VW, Fong TN, Au SK, Li M, Lam YYO, Wong CK, Kwok AW, Leung PC, Li EK, Tam LS
期刊名稱Journal of Bone and Mineral Research
出版年份2014
月份9
日期1
卷號29
期次9
出版社American Society for Bone and Mineral Research
頁次2118 - 2129
國際標準期刊號0884-0431
電子國際標準期刊號1523-4681
語言英式英語
關鍵詞BONE MICROSTRUCTURE; BONE STRENGTH; HIGH-RESOLUTION PQCT; INFLAMMATION; RHEUMATOID ARTHRITIS
Web of Science 學科類別Endocrinology & Metabolism; ENDOCRINOLOGY & METABOLISM

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