This study aimed to analyze the agreement between FRAX scores calculated with and without femoral neck (FN) bone mineral density (BMD) and to investigate the resultant treatment recommendations in women with osteopenia. A cross-sectional review of postmenopausal women who were referred for DXA evaluation was conducted. One hundred twenty-nine postmenopausal women aged 40 years and older with osteopenia [FN T-score between -1 and (-2.5)] were recruited for the study. Absolute agreement between FRAX scores calculated with and without BMD was analyzed by intraclass correlation analysis (ICC). Thresholds recommended by National Osteoporosis Foundation were used for treatment recommendations. Correlation between demographic factors and the difference in BMD+ and BMD- FRAX scores was analyzed by Spearman correlation test. Agreement levels and treatment recommendations were also analyzed in 112/129 patients without previous fracture. Agreement between BMD+ and BMD- MO and hip FRAX scores was good (ICC 0.867) and fair to good (ICC 0.641), respectively. In patients without previous fracture, agreement between MO and hip fracture probabilities was good (ICC = 0.838 and ICC = 0.778, respectively). Treatment recommendations with respect to treatment threshold of ≥3 for hip fracture probabilities were identical in 120/129 (93 %) cases. Difference between BMD+ and BMD- fracture probabilities was correlated with age and FN BMD. In most cases, FRAX without BMD provided the same treatment recommendations as FRAX with BMD in postmenopausal women with osteopenia. Exclusion of patients with previous fracture yielded better agreement levels.
Objective: Rheumatoid arthritis (RA) is a chronic, autoimmune, inflammatory disease primarily involving the synovial joints. Its etiology is still not exactly known. It is thought that osteopontin (OPN), produced in the rheumatoid synovium, plays an important role in RA. The studies are insufficient. OPN is an extracellular matrix protein secreted from cells, including osteoclasts, macrophages, and active T-cells. The aim of this study is to investigate the relationship between plasma osteopontin levels and disease activity. Material and Methods: Thirty female patients diagnosed with RA according to ACR criteria and 23 healthy subjects were included in the study. Demographic characteristics were recorded. Blood count, ESR, CRP, anti-CCP, alpha-1 antitrypsin, fibrinogen, routine biochemical tests, and plasma OPN levels were measured. Evaluation of disease activity and difficulty in daily life activities was done with DAS28, HAQ, and RAQoL, respectively. Results: The mean age of patients was 54.0±11.1 years. The mean duration of disease was 130.8±112.7 months. The mean value of DAS28 was 3.4±1.3. Plasma OPN levels of patients and healthy subjects were 19.9±14.3 and 14.0±8.8 (ng/mL), respectively. No statistical difference was found in OPN levels (p=0.07). Anti-CCP levels of patients and healthy subjects were 30.3±62.1 and 1.1±0.5 (u/mL), respectively. A strong correlation was found between OPN and anti-CCP levels (p<0.001) and platelet count (p<0.001), but no correlation was found between OPN levels and DAS28. A strong correlation was found between OPN and anti-CCP levels (p<0.001) and platelet count (p<0.001), but no correlation was found between OPN levels and DAS28. Conclusion: No correlation was found between plasma OPN levels and disease activity (p=0.35). Further studies with more patients need to be planned to reach a definite conclusion. The importance of OPN in the diagnosis of RA can be emphasized. Key Words: Disease activity, osteopontin, rheumatoid arthritis Özet Amaç: Romatoid artrit (RA); sebebi halen tam olarak bilinmeyen, öncelik-le sinovyal eklemleri tutan, kronik, otoimmün ve inflamatuvar bir hastalıktır. Romatoid sinovyumda üretilen Osteopontinin (OPN) RA'da önemli rol oynadığı düşünülmektedir, ancak bu konuda yeterince çalışma yoktur. Osteopontin osteoklastlar, makrofajlar ve aktif T hücreleri gibi çeşitli hüc-relerden salgılanan hücre dışı bir matriks proteinidir. Bu çalışmada, RA'lı hastalarda OPN plazma düzeylerinin hastalık aktivasyonuyla ilişkisinin araştırılması amaçlanmıştır. Gereç ve Yöntemler: Kliniğimizde takip edilmekte olan ve Amerikan Romatoloji Birliği (ACR) tanı kriterlerine göre RA tanısı almış 30 hasta ve 23 sağlıklı kontrol olmak üzere toplam 53 kadın çalışmaya alındı. Hastaların yaşları, hastalık süreleri kaydedildi. Her iki grupta da rutin biyokimyasal tetkikler, hemogram, ESH, CRP, anti-CCP, α1-antitripsin, fibrinojen ve plazma OPN düzeyleri araştırıldı. Hastalık aktivitesi DAS28 ile günlük yaşam aktivitelerindeki güçlük de HAQ ve RAQoL anketleriyle değerlen-dirildi...
AIM:To analyze the association between the severity of pain and individual radiographic features and global radiographic indexes in hip osteoarthritis (OA). MATERIALS AND METHODS:Forty-five consecutive patients who attended to our outpatient clinic with hip pain diagnosed as hip OA according to American College of Rheumatology (ACR) criteria were recruited for the study. Anteroposterior pelvic radiographs were obtained in all patients. Radiographs were read blindly and evaluated using Croft index, Lane index, individual radiographic features (IRF) of Lane index and Croft's measurement of the "minimal joint space" (MJS) and Kellgren-Lawrence grading by a radiologist. After radiographic evaluation Kellgren Lawrence grade 1 patients were excluded from the study and 38 patients with Kelgren Lawrence grade 2-4 hip OA patients were statistically analyzed. Correlation between the severity of pain evaluated by visual analog scale (VAS) and radiographic findings were statistically analyzed with Spearman correlation test. Linear regression analyses (stepwise method) were used to investigate associations between severity of pain and radiographic findings. JSN and osteophyte grading according to Lane index, MJS, MJS<2.5 mm and global indexes (KL,Croft,Lane) were chosen as independent variables in linear regression analyses. RESULTS:Mean age of patients was 60.76+13 years. 38 patients had Kellgren Lawrence grade 2-4 hip osteoarthritis. Joint space narrowing (JSN) grading according to Lane index (r =0.32 and p=0.05) and minimal joint space measurement <2.5 mm according to Croft index (r = -0.33 and p=0.04) showed correlation with severity of pain. No correlation was observed between osteophyte grading, sclerosis, cyst, deformity and global indexes and severity of pain (p> 0.05). Applying logistic regression analyses, only reduced minimum joint space (MJS) (cut off value set at 2.5 mm) was found to be significantly associated to the severity of pain (p=0.002.) CONCLUSION: Quantitative measurement and grading of joint space narrowing showed correlation with severity of pain in hip osteoarthritis patients. It is observed that the radiographic finding that is related to the severity of pain in hip OA was MJS< 2.5 mm. This finding should be confirmed with further studies of larger sample size of patients with different radiographic severity.
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