A Cross-Sectional Study of the Association between Autoantibodies and Qualitative Ultrasound Index of Bone in an Elderly Sample without Clinical Autoimmune Disease

Abstract

Bone loss is characteristic of the ageing process and a common complication of many autoimmune diseases. Research has highlighted a potential role of autoantibodies in pathologic bone loss. The confounding effects of immunomodulatory drugs make it difficult to establish the contribution of autoantibodies amongst autoimmune disease sufferers. We attempted to examine the relationship between autoantibodies and bone mass in a population of 2812 elderly participants without clinical autoimmune disease. Serum samples were assayed for a panel of autoantibodies (anti-nuclear, extractable nuclear antigen, anti-neutrophil cytoplasmic, thyroid peroxidase, tissue transglutaminase, anti-cardiolipin, rheumatoid factor, and cyclic citrullinated peptide). Bone mass was measured using quantitative ultrasound (QUS) of the calcaneus. The relationship between each autoantibody and bone mass was determined using linear regression models. Anti-nuclear autoantibodies were the most prevalent, positive in approximately 11%, and borderline in roughly 23% of our sample. They were also the only autoantibody observed to be significantly associated with QUS index in the univariate analysis (n = 1628; r = −0.20; 95% CI: −0.40–0.00; p = 0.046). However, statistical significance was lost after adjustment for various other potential confounders. None of the other autoantibodies was associated with QUS index in either univariate or multivariate analysis. We are limited by the cross-sectional nature of the study and the low prevalence of autoantibodies in our nonclinical sample.

Population-based estimates of humoral autoimmunity from the U.S. National Health and Nutrition Examination Surveys, 1960–2014

“…Thus, the NHANES data, although based on a limited number of autoantibodies, directly challenge assertions that autoantibodies are uncommon. In retrospect, these findings should not come as a surprise because, historically, both at the inception of early humoral autoimmunity studies and periodically thereafter, small-scale surveys using differing laboratory methodologies have shown similar results [71][72][73].…”

Effects of 6-Month Multimodal Physical Exercise Program on Bone Mineral Density, Fall Risk, Balance, and Gait in Patients with Alzheimer’s Disease: A Controlled Clinical Trial

“…QUS is a noninvasive method for estimating bone mineral status of the peripheral skeleton. Dual-energy X-ray absorptiometry (DEXA) is currently considered the gold standard and comprises an accurate technique used to measure BMD at specific fracture-related sites, although QUS has been considered a valid and useful measure for determining bone health status in older people [ 77 , 78 , 79 ]. In addition to bone density, QUS provides some structural information that may be important in determining fracture risk [ 41 ] and identifying patients at risk of developing osteoporosis.…”

“…In addition to bone density, QUS provides some structural information that may be important in determining fracture risk [ 41 ] and identifying patients at risk of developing osteoporosis. QUS offers wider accessibility because it is portable, easier to handle, lower in cost, and does not emit ionizing radiation [ 41 , 77 , 78 , 79 ].…”

Short and medium-term effects of a multicomponent physical exercise program with a Mediterranean diet on bone mineral density, gait, balance, and fall risk for patients with Alzheimer disease

“…It is a safe, radiation-free modality that provides precise quantitative assessment of skeletal status, useful information in elderly for identifying patients at risk of developing osteoporosis and for assessing their risk of future fracture. [ 79 , 80 , 86 ] Bone mass we will measured at the calcaneus (95% of trabecular bone) by using QUS (Sahara Hologic Clinical Bone Sonometer; Hologic lnc., Waltham, MA). QUS parameters will be measured, but we consider the estimated BMD (g/cm 2 ) and T-score (comparison of the average mineral density of the patient's bone with a healthy young people) as primary outcome, because some researchers suggested that these parameters are more useful in the determination of subjects with low bone health status.…”

“…QUS parameters will be measured, but we consider the estimated BMD (g/cm 2 ) and T-score (comparison of the average mineral density of the patient's bone with a healthy young people) as primary outcome, because some researchers suggested that these parameters are more useful in the determination of subjects with low bone health status. [ 79 – 81 , 86 ]…”