Background Rheumatoid arthritis (RA) itself is associated with osteoporosis that may be localized or generalized. Joint inflammation in RA induces local periarticular osteoporosis. And the bone loss in the hands and generalized osteoporosis was reported to be correlated.

Objectives To determine the levels of bone turnover markers in patients with rheumatoid arthritis (RA) and the correlation with disease activity index, bone mineral density (BMD) and radiographic progression.

Methods Sixty-eight postmenopausal women with RA were recruited in our study. Serologic measurement including erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor (RF) and anti-cyclic citrullinated peptid (anti-CCP) were analyzed. Calcium, vitamin D, bone alkaline phosphatase (BAP) β-crosslaps were also detected. Bone mineral density (BMD, g/cm²) was measured at the lumbar spine and the left femoral neck by dual-energy X-ray absorptiometry (DXA). DAS28 and Sharp score were separately calculated for disease activity and radiographic progression evaluation. Spearman correlation analysis was conducted between clinical biomarkers and disease indexes.

Results The overall rate of patient with abnormal BMD was 94.12%, with osteopenia 29.41% (20/68) and osteoporosis 64.71% (44/68), respectively. ESR, CRP and DAS28 was significantly correlated with each other showing consistent disease activity (p<0.05). Serum β-crosslaps level (452.87±202.40 ug/l) was not correlated with any of disease acidity markers (p all >0.05) and positively correlated with Sharp score (150.76±59.71) in postmenopausal women with RA (r=0.776, p=1×10–6).

Conclusions Osteopenia and osteoporosis was predominant in RA which might be related to disease activity and/or structural damage. β-crosslaps implies radiographic progression instead of disease activity.

1. Desai SP, Gravallese EM, Shadick NA, Glass R, Cui J, Frits M, et al. Hand bone mineral density is associated with both total hip and lumbar spine bone mineral density in post-menopausal women with RA. Rheumatology (Oxford) 2010;49(3):513–9.

2. Nolla JM, Roig-Vilaseca D, Gomez-Vaquero C, Mateo L, Juanola X, Rodriguez-Moreno J, et al. Frequency of osteoporosis in 187 men with rheumatoid arthritis followed in a university hospital. J Rheumatol 2006;33(8):1472–5.

3. Fiter J, Nolla JM, Navarro MA, Gόmez-Vaquero C, Rosel P, Mateo L, et al. Weak androgen levels, glucocorticoid therapy, and bone mineral density in postmenopausal women with rheumatoid arthritis. Joint Bone Spine 2000;67(3):199–203.

4. Chen J, Liu W, Lin Q, Chen L, Yin J, Huang H. Vitamin D deficiency and low bone mineral density in native Chinese rheumatoid arthritis patients. Int J Rheum Dis 2014;17(1):66–70

5. Hall GM, Spector TD, Delmas PD. Markers of bone metabolism in postmenopausal women with rheumatoid arthritis. Effects of corticosteroids and hormone replacement therapy. Arthritis Rheum 1995;38(7):902–6.

Disclosure of Interest None declared