The relationship between bone mineral density and levels of RANKL, osteoprotegerin and cathepsin-K in patients with rheumatoid arthritis

Abstract

Bu çalışmanın amacı Romatoid Artrit'li (RA) hastalarda Osteoprotegerin (OPG), Nükleer faktör kappa B reseptör aktivatörü ligandı (RANKL), katepsin-K düzeylerini ve ayrıca bu parametrelerin kemik mineral yoğunluğu (BMD) ile ilişkisini araştırmaktır. Gereç ve yöntem: Çalışmaya postmenopozal sağlıklı (n=30), postmenopozal osteoporozlu (n=30) ve postmenopoz RA'lı (n=30) toplam 90 olgu alındı. Serum RANKL, OPG ve katepsin-K ELİSA yöntemiyle çalışıldı. Bulgular: Postmenopozal RA' lı hastalarda serum RANKL ve OPG seviyeleri postmenopozal sağlıklı kontrollere kıyasla anlamlı yüksekken, serum OPG/RANKL oranı anlamlı düşük bulundu. Bununla birlikte postmenopozal RA'lı hastalarda, postmenopozal osteoporozlu hastalara göre serum OPG ve OPG/RANKL oranı anlamlı düşük iken, serum RANKL seviyesi anlamlı yüksekti. Postmenopozal RA'lı hastalarda lomber spine (LS) ve femur neck (FN) kemik mineral dansiteleri (BMD) ile OPG/RANKL oranı arasında pozitif korelasyon saptanırken; RANKL düzeyleri ile negatif korelasyon bulundu. Sonuç: RANKL/RANK/OPG sistemi osteoporoz ve RA patogenezinde rol alabilmektedir ve OPG/RANKL oranı kemik dansitesinin önemli bir belirleyicisi olabilir.

Serum levels of osteoprotegerin and RANKL in patients with rheumatoid arthritis and their relation to bone mineral density and disease activity

“…In this study, BMD values in RA were obviously lower than that in controls at positions of all the detected regions. Changes of overall bone mass in this study were similar to the results of other researches [23][24][25].…”

“…This agrees with a study that enrolled 30 postmenopausal healthy women, 30 with postmenopausal osteoporosis and 30 with postmenopausal RA; a significant correlation was detected between bone densities of lumbar spine (LS) and femur neck (FN) with the OPG/RANKL ratio in patients with postmenopausal RA. Also, a negative correlation was detected between LS and FN bone densities and RANKL levels [23].…”

The association of serum RANKL levels with disease activity and hematological parameters in Syrian patients with rheumatoid arthritis

“…Carmen study et al in Spain showed that serum RANKL values were below the detection limit in 85% of RA patients because 76% of them were in clinical remission or in low disease activity [ 40 ]. Our study also found an elevation in RANKL levels in post-menopausal patients compared to post-menopausal healthy group, this confirms its importance in bone loss and pathogenic mechanism of rheumatoid arthritis as found a similar in Çakırca et al study in Turkey [ 41 ]. There was a significant increase in serum RANKL levels in ACPA sero-positive RA patients’ group compared with ACPA seronegative.…”

Associations of serum sclerostin with bone mineral density, markers of bone metabolism and thalassaemia characteristics in adult patients with transfusion-dependent beta-thalassaemia

“…On the other hand, our results are contradictory to the conclusions of in-vitro and animal studies which have shown that OPG plays a protective role in bone methabolism [59]. To cast some light on this contradiction, we draw on the findings of clinical studies with different patient populations [60,61] whose findings suggest that the protective role of OPG in bone metabolism may not be as straigforward as generally thought. For instance, Sherief et al observed increased OPG levels in beta-thalassaemia patients in association with their atherosclerotic changes [62].…”

“…Two significant relationships were found: a negative association with Hb (r s ¼ À 0.423, 95%CI À0. 60 Figure 4 shows the significant association of sclerostin levels with Hb and LIC. Higher sclerostin levels are associated with lower Hb levels and with higher LIC values.…”