title: Accelerated metacarpal bone mineral density loss is associated with radiographic progressive hand osteoarthritis.
abstract: OBJECTIVE
  To study the association between metacarpal bone mineral density (BMD) loss and progressive hand osteoarthritis (OA) over 2 years.
  
  
  METHODS
  Using the Kellgren-Lawrence (KL) grading scale and the Osteoarthritis Research Society International Atlas, standardised hand radiographs of 181 patients with primary OA at multiple sites (mean age 60 years, 80% women, mean body mass index 27 kg/m(2)) were assessed for hand OA at baseline (KL ≥ 2 in two or more hand joints) and progressive hand OA over 2 years (≥ 1 point increase in total osteophyte and joint space narrowing score in patients with hand OA at baseline). Changes in BMD were measured over 2 years in metacarpals 2-4 by digital x-ray radiogrammetry. Accelerated BMD loss was defined as loss of >3 mg/cm(2)/year. Logistic regression analyses were performed to assess the associations between BMD loss and progressive hand OA.
  
  
  RESULTS
  The baseline prevalence of hand OA was 68% and, after 2 years, 32% of these patients had progressive hand OA. Accelerated BMD loss was present in 79% of the patients with progressive hand OA compared with 60% and 57% of the patients with non-progressive hand OA and no hand OA, respectively. BMD loss was independently associated with progressive hand OA compared with non-progressive hand OA with a RR (95% CI) of 2.1 (1.1 to 4.3).
  
  
  CONCLUSIONS
  Accelerated metacarpal BMD loss is associated with progressive hand OA over a period of 2 years; knowledge of common mechanisms may lead to development of therapeutic interventions for hand OA.
authors.affiliation: Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands. m.yuksel@lumc.nl
authors.forename: M
authors.initials: M
authors.lastname: Güler-Yüksel
authors.forename: J
authors.initials: J
authors.lastname: Bijsterbosch
authors.forename: C F
authors.initials: CF
authors.lastname: Allaart
authors.forename: I
authors.initials: I
authors.lastname: Meulenbelt
authors.forename: H M
authors.initials: HM
authors.lastname: Kroon
authors.forename: I
authors.initials: I
authors.lastname: Watt
authors.forename: W F
authors.initials: WF
authors.lastname: Lems
authors.forename: M
authors.initials: M
authors.lastname: Kloppenburg
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D015519:Bone Density / Q000502:physiology; D002097:C-Reactive Protein / Q000032:analysis; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D050823:Hand Joints / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D050279:Metacarpal Bones / Q000503:physiopathology*; D008875:Middle Aged; D010003:Osteoarthritis / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D010024:Osteoporosis / Q000150:complications* / Q000503:physiopathology; D011859:Radiography; D012720:Severity of Illness Index; D012737:Sex Factors
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein