Study on the Correlation Between Bone Metabolism Markers and Bone Mineral Density in Patients with Rheumatoid Arthritis

NIAN Shaoshuo; XU Wenkun; LU Haijing

doi:10.13919/j.issn.2095-6274.ZHJY202412008

Abstract：Objective Analyze the levels of bone metabolism indicators and bone density in patients with rheumatoid arthritis,and further explore their correlation.Methods A retrospective analysis was conducted on the clinical data of 148 patients with rheumatoid arthritis admitted to Quanzhou Orthopedic Hospital from March 2021 to March 2023.Select 100 healthy individuals who underwent physical examinations during the same period as controls.The Disease Activity Rating System for Rheumatoid Arthritis(DAS28)was used to grade patients with rheumatoid arthritis.The levels of type I procollagen N-terminal peptide(P1NP),type I collagen carboxyterminal peptide beta special sequence(β-CTX),25 hydroxyvitamin D(25-OHVD),N-terminal midpiece osteocalcin(N-MID),and bone density(L1-4 lumbar vertebrae,femoral neck)were compared between patients with different grades of rheumatoid arthritis and a healthy control group.And use Pearson correlation analysis to investigate the correlation between bone metabolism indicators and bone density.Results Compared with the healthy control group,patients with rheumatoid arthritis grades II,III,and IV had lower levels of P1NP,25-OHVD,and N-MID in their serum(P<0.05),and higher levels of β-CTX(P<0.05);There was no significant difference in the levels of the above bone metabolism indicators in the serum of rheumatoid arthritis grade I patients(P>0.05).As the grading of rheumatoid arthritis increases,the levels of serum P1NP,25-OHVD,and N-MID decrease sequentially(P<0.001),while the levels of β-CTX in-crease sequentially(P<0.001).Compared with the healthy control group,patients with rheumatoid arthritis grade III and IV had lower bone density levels in the lumbar spine and femoral neck(P<0.05);There was no significant dif-ference in bone density levels between patients with rheumatoid arthritis grade I and II in the above-mentioned ar-eas(P>0.05).The bone mineral density levels of lumbar spine and femoral neck in patients with different grades of rheumatoid arthritis decrease sequentially with the increase of grading(P<0.001).According to Pearson correlation analysis,the levels of P1NP,25-OHVD,and N-MID in the serum of rheumatoid arthritis patients are positively correlated with bone density levels(γ>0.9,P<0.05);The level of β-CTX is negatively correlated with bone densi-ty(γ=-0.970,P<0.05).Conclusion Serum bone metabolism indicators and bone density levels can dynamically reflect the severity of rheumatoid arthritis patients to a certain extent.