title: Antibodies to cyclic citrullinated protein and erythrocyte sedimentation rate predict hand bone loss in patients with rheumatoid arthritis of short duration: a longitudinal study.
abstract: BACKGROUND
  Radiographic progression in rheumatoid arthritis (RA) has in several studies been shown to be predicted by serological markers widely used in daily clinical practice. The objective of this longitudinal study was to examine if these serological markers also predict hand bone mineral density (BMD) loss in patients with RA of short disease duration.
  
  
  METHODS
  163 patients with RA of short disease duration (2.4 years) were included and followed longitudinally. Antibodies to cyclic citrullinated protein (anti-CCP), rheumatoid factor (RF), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) were analysed from baseline blood-samples. Hand BMD was measured by digital X-ray radiogrammetry (DXR) based on hand and wrist radiographs obtained at baseline and 1, 2 and 5-year follow-up.
  
  
  RESULTS
  During the study period, DXR-BMD decreased by median (inter quartile range) 1.7% (4.1 to 0.4), 2.8% (5.3 to 0.9) and 5.6% (11.7 to 2.3) after 1, 2 and 5 years, respectively. Elevated baseline anti-CCP, RF, ESR and CRP levels were in univariate linear regression analyses consistently associated with DXR-BMD change at all time-points. Anti-CCP and ESR were independently associated with hand DXR-BMD in multivariate linear regression analyses. Elevated anti-CCP levels were consistent and independent predictors of loss in cortical hand bone during the study period, with the odds ratios (95% confidence interval) 2.2 (1.0 to 4.5), 2.6 (1.1 to 6.2) and 4.9 (1.4 to 16.7) for the 1, 2, and 5-year follow-up periods, respectively.
  
  
  CONCLUSIONS
  Anti-CCP and ESR were found to be independent predictors of early localised BMD loss. This finding adds to the understanding of anti-CCP and ESR as important predictors of bone involvement in RA.
authors: Department Rheumatology, Diakonhjemmet Hospital, Diakonveien 12, Oslo, Norway. pernilleboyesen@gmail.com
authors: Pernille
authors: P
authors: Bøyesen
authors: Mari
authors: M
authors: Hoff
authors: Sigrid
authors: S
authors: Odegård
authors: Glenn
authors: G
authors: Haugeberg
authors: Silje W
authors: SW
authors: Syversen
authors: Per I
authors: PI
authors: Gaarder
authors: Cecilie
authors: C
authors: Okkenhaug
authors: Tore K
authors: TK
authors: Kvien
mesh_terms: D015502:Absorptiometry, Photon; D000328:Adult; D001172:Arthritis, Rheumatoid / Q000097:blood* / Q000276:immunology / Q000473:pathology*; D001323:Autoantibodies / Q000097:blood*; D001324:Autoantigens / Q000097:blood; D015415:Biomarkers / Q000097:blood; D001799:Blood Sedimentation; D015519:Bone Density / Q000276:immunology; D001862:Bone Resorption / Q000097:blood / Q000209:etiology* / Q000276:immunology; D002097:C-Reactive Protein / Q000276:immunology; D018450:Disease Progression; D005260:Female; D050276:Hand Bones / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010456:Peptides, Cyclic / Q000276:immunology; D012217:Rheumatoid Factor / Q000276:immunology
chemical_list: D001323:Autoantibodies; D001324:Autoantigens; D015415:Biomarkers; D010456:Peptides, Cyclic; C487763:cyclic citrullinated peptide; D002097:C-Reactive Protein; D012217:Rheumatoid Factor