| Objective To investigate the relationship between serum bone metabolic markers and joint destruction in patients with rheumatoid arthritis ( RA).Methods One hundred and forty hospitalized RA patients and 90 healthy controls were selected as study subjects.Bone mineral density of the lumbar spine 1-4 and the proximal femus was measured using DEXA.Based on the T values, they were divided to 3 groups:normal bone mass, low bone mass, and osteoporosis group.According to X-ray reports of the extent of the joint damage, RA patients were divided into stage I, II, III, and IV groups.Serum CTX, 25 ( OH) D, TRACP-5b, PTH, serum calcium, serum phosphorus, anti-CCP antibodies, RF, CRP, and ESR were also detected.Results TRACP-5b and CTX in RA group were significantly higher than those in the control group (Z=-2.747, -4.809, P<0.01), but 25 (OH) D was significantly lower than that in the control group (Z=-6.152, P<0.001).The concentration of TRACP-5b was positively correlated with disease duration, number of joint tenderness, and CTX (r=0.193, r=0.189, r=0.196, P<0.05).TRACP-5b showed an increasing trend with the aggravation of disease activity, and its concentration in osteoporosis group was higher than that in normal bone mass group, but with no statistical difference.CTX was positively correlated with the number of swollen joints and 25 (OH) D (r=0.215, r=0.192, P<0.05), and it was obviously higher in severe disease activity group than in the middle and lower group.Compared with the other groups, patients in stage I grou had younger age, shorter duration, and less seriously joint damage.The prevalence of osteoporosis in stage I or II groups was distinctly lower than that in stage III and IV groups (P<0.05). The decrease of bone mass was positively correlated with age, duration and the aggravation of the disease activity.Conclusion There is a good correlation between bone metabolic markers and joint damage in patients with RA.The detection of multiple markers of bone metabolism may predict joint destruction. |