title: Bone metabolism and histomorphometric changes in rheumatoid arthritis.
abstract: OBJECTIVE
  We studied bone metabolism and histomorphometry in 66 patients with rheumatoid arthritis.
  
  
  METHODS
  Cross-sectional study.
  
  
  RESULTS
  BMD at the forearm but not at the lumbar spine was decreased. Age. body mass index and fibrinogen correlated significantly with decreased BMD, whereas age and disease duration were predictors of vertebral fractures. Biochemical parameters were normal but 25 vitamin D levels were markedly reduced. There were significant decreases in bone volume, mean wall thickness, mineral apposition rate (with highly prolonged mineralisation lag time), number of osteoclasts, and osteoclast surface, and increases in resorption surfaces. Mean plate trabecular separation and density were also deeply affected.
  
  
  CONCLUSIONS
  Patients with rheumatoid arthritis showed a reduced bone volume and decreased bone turnover, which is further aggravated by microarchitectural deterioration stressing the severe osteoporosis associated with the disease. These findings are consistent with the effect of hypovitaminosis D and low values of vitamin D in serum.
authors.affiliation: Service of Rheumatology, Hospital de la Esperanga and Hospital del Mar, Barcelona, Spain. 18576@imas.imim.es
authors.forename: Luis
authors.initials: L
authors.lastname: Pérez-Edo
authors.forename: Adolfo
authors.initials: A
authors.lastname: Díez-Pérez
authors.forename: Lluisa
authors.initials: L
authors.lastname: Mariñoso
authors.forename: Antonio
authors.initials: A
authors.lastname: Vallés
authors.forename: Sergi
authors.initials: S
authors.lastname: Serrano
authors.forename: Jordi
authors.initials: J
authors.lastname: Carbonell
mesh_terms: D015502:Absorptiometry, Photon; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000378:metabolism* / Q000473:pathology*; D001706:Biopsy; D015519:Bone Density / Q000502:physiology; D001842:Bone and Bones / Q000378:metabolism* / Q000473:pathology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007085:Ilium / Q000378:metabolism / Q000473:pathology; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications / Q000000981:diagnostic imaging / Q000378:metabolism*; D011884:Radius / Q000378:metabolism / Q000473:pathology; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000209:etiology / Q000378:metabolism*; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000378:metabolism