Objectives The aim of our recent study was to evaluate bone metabolism in rheumatoid arthritis (RA) and systemic lupus erythematosus patients (SLE).
Methods 306 women (90 RA, 38 SLE patients and 178 healthy volunteers) were involved in the study. All SLE and 44 RA patients were on chronic glucocorticosteroids theraphy (GCS). Average age was: 46.4 ± 12.8 yrs, 52.0 ± 12.0 yrs in SLE group and the control (respectively). Disease duration and duration of GCS therapy in SLE patients was: 108 ± 82 months. Total dose of GCS was the highest in SLE pts (25.3 ± 28.19 g). Patients with RA were divided into two groups: treated with GCS (average age: 52.5 ± 12.4 yrs, disease duration and duration of GCS therapy: 122 ± 102 months, total dose of GCS: 7.4 ± 8.3 g): and who were not treated with GCS (average age: 54.3 ± 9.7 yrs, disease duration: 134 ± 120 months). In all patients the following markers of bone metabolism were measured: osteocalcin, procolagen C, alkaline phosphatase-bone fraction, carboxyterminal telopeptides of type I collagen (CTX), procollagen type I carboxyterminal propeptide (PICP), deoxypyridynoline. The disease activity was assessed by measuring serum levels of proinflammatory cytokines (IL-1a, IL-6, TNF-alpha, GM-CSF) and acute phase markers (ESR, CRP, AGP, AGP-RC, ACT).
Results Concentration of biochemical markers of osteoporosis suggesting increased bone metabolism in RA patients indicates significantly higher bone loss in this group than in SLE patients in spite of the highest dosage of GCS. There was no significantly differences between bone turnover in RA patients treated and not treated with GCS.
Conclusion The serum levels of proinflammatory cytokines and acute phase markers confirm the highest stage of the disease activity in RA patients.
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