RESEARCH - Hypercalcemia in RA: relationship with disease activity and bone metabolism

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Rheumatol Int. 2006 Aug;26(10):908-15. Epub 2006 Jan 11.

Hypercalcemia in rheumatoid arthritis: relationship with disease activity

and bone metabolism.

Division of Rheumatology/Osteology, Department of Internal Medicine III,

Friedrich-Schiller University, Erlanger Allee 101, 07740, Jena, Germany,

peter.oelzner@....

To investigate the relationship between ionized calcium and disease

activity, parameters of bone metabolism and bone mineral density (BMD) at

the lumbar spine (BMD-LS) and the femoral neck (BMD-FN) measured by dual

X-ray absorptiometry in rheumatoid arthritis (RA). In 146 patients with RA,

the following parameters were investigated: serum levels of ionized calcium,

total calcium, vitamin D metabolites 25-hydroxyvitamin D3 (25D3) and

1,25-dihydroxyvitamin D3 (1,25D3), intact parathyroid hormone (iPTH),

interleukin-6, osteocalcin, erythrocyte sedimentation rate (ESR) and

c-reactive protein (CRP); renal excretion of pyridinolin (PYD)- and

desoxypyridinolin (DPD)-crosslinks. A total of 30.1% of the patients were

hypercalcemic (ionized calcium >1.30 mmol/l). In comparison with

normocalcemic patients, those with hypercalcemia had significantly higher

ESR (P<0.01) and CRP values (P<0.05) and significantly lower serum levels of

both iPTH (P<0.01) and 1,25D3 (P<0.05) and a significantly lower BMD-LS

(P<0.05). The results indicate that a substantial part of RA patients is

hypercalcemic. Hypercalcemia is associated with high disease activity and

may contribute to suppression of PTH secretion and vitamin D hormone

synthesis. High levels of ionized calcium may be a reflection of

disease-activity-related systemic bone loss, and could be a predictor of BMD

at the lumbar spine in RA.

PMID: 16404562

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed & cmd=Retrieve & dopt=Abstra\

ctPlus & list_uids=16404562

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