Unbalanced Bone Turnover Seen in Spondyloarthropathies

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Unbalanced Bone Turnover Seen in Spondyloarthropathies

NEW YORK (Reuters Health) Jul 31 - Bone resorption markers are elevated in

patients with spondyloarthropathies, particularly those with ankylosing

spondylitis, Austrian researchers report in the July issue of The Journal of

Rheumatology.

Dr. Johannes Grisar and colleagues at the University of Vienna measured

urinary deoxypyridinoline and cross-linked telopeptide collagen-1 (measures

of bone resorption), and bone-specific alkaline phosphatase,

osteoprotoglycan and osteocalcin (measures of bone formation) in 40 patients

with spondyloarthropathies and in a group of 41 healthy controls. The

researchers also took dual energy x-ray absorptiometry (DEXA) measurements

of the lumbar spine and femoral neck.

The researchers report that bone resorption markers were elevated in all

patients. In patients with psoriatic arthritis, elevated levels of bone

resorption markers correlated with acute phase of disease, as measured by

C-reactive protein and erythrocyte sedimentation rate. DEXA was normal in

patients with psoriatic arthritis but showed osteopenia in patients with

ankylosing spondylitis.

Bone formation markers varied according to disease, the investigators found.

Alkaline phosphatase levels were increased in patients with psoriatic

arthritis but not in patients with ankylosing spondylitis or reactive

arthritis. Osteocalcin levels were increased in ankylosing spondylitis only.

Dr. Grisar's team notes that " taken together, our findings indicate enhanced

bone resorption in...ankylosing spondylitis, psoriatic arthritis and

reactive arthritis. "

They continue, " Differences in markers of bone formation may represent

significant differences between spondyloarthropathies. " They surmise that

elevated biochemical marker levels in all three diseases may be attributable

to inflammation-induced production of cytokines, and might reflect

overactivity of the osteoclast-osteoblast system.

J Rheumatol 2002;29:1430-1436.

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