Serological bone markers and joint damage in early polyarthritis.
OBJECTIVE
To investigate the relationship between osteocalcin (OC), a marker of bone formation, and the recently developed serum marker of bone resorption, beta-C-telopeptide (beta-CTx), and radiographic damage in patients with early oligo- and polyarthritis.


METHODS
Patients with peripheral arthritis of > or = 2 joints and < 2 years of symptom duration were studied. The OC and beta-CTx concentrations at baseline were correlated with disease activity and radiographic damage at baseline, and with radiographic progressive disease after 2 years (delta Sharp/van der Heijde score > or = 5). The additional value of serum bone metabolism markers to predict radiographic progressive disease was compared to that of established prognostic factors by multivariate logistic regression analysis.


RESULTS
Two hundred seventy-nine patients (67% female; median age 56 yrs, range 18-83) were included in the study, of whom 73% were diagnosed with rheumatoid arthritis (RA). Baseline levels of beta-CTx (p < 0.05) were significantly correlated with baseline radiographic damage whereas OC was not. beta-CTx was also significantly (p < 0.001) related to measures of disease activity like erythrocyte sedimentation rate, C-reactive protein, and the disease activity score DAS28. Radiographic progressive disease after 2 years corresponded univariately with increased levels of beta-CTx (p < 0.001), but not with OC. In multivariate analysis, beta-CTx was not superior to other measures of radiographic progressive disease such as autoantibodies and disease activity.


CONCLUSIONS
Increased serum levels of the bone turnover marker beta-CTx are associated with radiographic damage at baseline and radiographic progression after 2 years. However, beta-CTX is less predictive than markers already in use.
Jan van Breemen Instituut and the Department of Rheumatology, Vrije Universiteit Medical Centre, Amsterdam, The Netherlands.
Louise M A
LM
Jansen
Irene
I
van der Horst-Bruinsma
Willem F
WF
Lems
Dirkjan
D
van Schaardenburg
Rob
R
van de Stadt
Margret
M
de Koning
Ben A C
BA
Dijkmans
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001168:Arthritis / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000378:metabolism* / Q000503:physiopathology; D001175:Arthrography; D015415:Biomarkers / Q000097:blood; D001862:Bone Resorption / Q000378:metabolism; D001842:Bone and Bones / Q000378:metabolism*; D003094:Collagen / Q000097:blood* / Q000378:metabolism; D024042:Collagen Type I; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015675:Osteocalcin / Q000097:blood* / Q000378:metabolism; D010012:Osteogenesis; D010455:Peptides / Q000097:blood* / Q000378:metabolism; D011237:Predictive Value of Tests; D020033:Protein Isoforms / Q000097:blood / Q000378:metabolism
D018501:Antirheumatic Agents; D015415:Biomarkers; D024042:Collagen Type I; D010455:Peptides; D020033:Protein Isoforms; C052929:collagen type I trimeric cross-linked peptide; D015675:Osteocalcin; D003094:Collagen