Antibodies to cyclic citrullinated protein and erythrocyte sedimentation rate predict hand bone loss in patients with rheumatoid arthritis of short duration: a longitudinal study

IntroductionRadiographic circuit in rheumatoid arthritis (RA) has in many studies been shown to be predicted by serological markers widely used in diurnal clinical practice. The mark of this longitudinal study was to study whether these serological markers as well predict ability bone mineral density (BMD) loss in patients with RA of short disease duration. Methods: 163 patients with RA of short disease lifetime (2.4 years) were included and followed longitudinally. Antibodies to cyclic citrullinated protein (anti-CCP), rheumatoid baggage (RF), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) were analyzed from baseline blood-samples. Hand BMD was measured by digital Cathode rays radiogrammetry (DXR) based on participation 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 interchange 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 help bone during the interpret period, with the odds ratios (95% confidence interval) 2.2 (1.0 to 4.5), 2.6 (1.1-6.2) and 4.9 (1.4-16.7) 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 sensitive of anti-CCP and ESR as chief predictors of bone involvement in RA.

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