PDF(Pubmed)
Abstract：
UNASSIGNED: FRAX® is a tool used for evaluation of risk of fracture in RA and non-RA patients and to identify those eligible for intervention. One of the limitations of FRAX in RA settings is that it does not consider factors known to contribute to osteoporosis such as autoantibodies. This study analysed the association of anti-mutated citrullinated vimentin antibody (anti-MCV), anti-cyclic citrullinated peptide antibody (anti-CCP), IgM rheumatoid factor (RF), IgA RF with 10-year risk of major osteoporosis and hip fracture.
UNASSIGNED: FRAX® tool was used to estimate 10-year risk of major osteoporosis fracture and hip fracture in 189 RA patients over 40 years of age. Anti-MCV, anti-CCP, IgM RF and IgA RF were tested using enzyme immunoassay and analysed at different levels. Results were adjusted for various confounders including disease activity.
UNASSIGNED: Fifty-one (26.9%) RA patients had high (≥20%) 10-year risk of major osteoporosis fracture and 67 (35.4%) had high (>3%) 10-year risk of hip fracture. Among all the tested autoantibodies, only IgM RF at elevated levels was associated with high 10-year risk of major osteoporosis fracture (adjusted OR = 4.1, 95% CI = 1.5-11.3, p = 0.006) and of hip fracture (adjusted OR = 17.4, 95% CI = 3.7-81.3, p < 0.0001). There was no agreement between FRAX and femoral neck (FN) BMD. None of the autoantibodies tested were associated with FN osteopenia or osteoporosis including IgM RF at high levels.
UNASSIGNED: Our study highlights the importance of quantitative measurement of autoantibodies in assessment of risk for fractures among RA patients. Our preliminary findings need to be assessed in prospective studies to determine the actual predictive value of high IgM RF levels among patients with RA.
UNASSIGNED: FRAX® tool was used to estimate 10-year risk of major osteoporosis fracture and hip fracture in 189 RA patients over 40 years of age. Anti-MCV, anti-CCP, IgM RF and IgA RF were tested using enzyme immunoassay and analysed at different levels. Results were adjusted for various confounders including disease activity.
UNASSIGNED: Fifty-one (26.9%) RA patients had high (≥20%) 10-year risk of major osteoporosis fracture and 67 (35.4%) had high (>3%) 10-year risk of hip fracture. Among all the tested autoantibodies, only IgM RF at elevated levels was associated with high 10-year risk of major osteoporosis fracture (adjusted OR = 4.1, 95% CI = 1.5-11.3, p = 0.006) and of hip fracture (adjusted OR = 17.4, 95% CI = 3.7-81.3, p < 0.0001). There was no agreement between FRAX and femoral neck (FN) BMD. None of the autoantibodies tested were associated with FN osteopenia or osteoporosis including IgM RF at high levels.
UNASSIGNED: Our study highlights the importance of quantitative measurement of autoantibodies in assessment of risk for fractures among RA patients. Our preliminary findings need to be assessed in prospective studies to determine the actual predictive value of high IgM RF levels among patients with RA.
摘要：
■FRAX®是一种用于评估RA和非RA患者骨折风险并确定符合干预条件的工具。FRAX在RA设置中的局限性之一是它不考虑已知有助于骨质疏松症的因素，例如自身抗体。本研究分析了抗突变型瓜氨酸波形蛋白抗体（抗MCV），抗环瓜氨酸肽抗体（抗CCP），IgM类风湿因子(RF),IgARF与严重骨质疏松症和髋部骨折的10年风险。
■FRAX®工具用于评估189名40岁以上RA患者发生严重骨质疏松性骨折和髋部骨折的10年风险。抗MCV,反CCP,使用酶免疫分析法对IgMRF和IgARF进行了测试，并在不同水平上进行了分析。结果针对包括疾病活动性在内的各种混杂因素进行了调整。
■51例（26.9%）RA患者发生严重骨质疏松性骨折的10年风险高（≥20%），67例（35.4%）患者发生髋部骨折的10年风险高（>3%）。在所有测试的自身抗体中，只有升高的IgMRF水平与严重骨质疏松性骨折(校正OR=4.1,95%CI=1.5-11.3,p=0.006)和髋部骨折(校正OR=17.4,95%CI=3.7-81.3,p<0.0001)的10年高风险相关.FRAX和股骨颈（FN）BMD之间没有一致性。所测试的自身抗体均未与FN骨质减少或骨质疏松症相关，包括高水平的IgMRF。
■我们的研究强调了定量测量自身抗体在评估RA患者骨折风险中的重要性。我们的初步发现需要在前瞻性研究中进行评估，以确定RA患者中高IgMRF水平的实际预测价值。
■FRAX®工具用于评估189名40岁以上RA患者发生严重骨质疏松性骨折和髋部骨折的10年风险。抗MCV,反CCP,使用酶免疫分析法对IgMRF和IgARF进行了测试，并在不同水平上进行了分析。结果针对包括疾病活动性在内的各种混杂因素进行了调整。
■51例（26.9%）RA患者发生严重骨质疏松性骨折的10年风险高（≥20%），67例（35.4%）患者发生髋部骨折的10年风险高（>3%）。在所有测试的自身抗体中，只有升高的IgMRF水平与严重骨质疏松性骨折(校正OR=4.1,95%CI=1.5-11.3,p=0.006)和髋部骨折(校正OR=17.4,95%CI=3.7-81.3,p<0.0001)的10年高风险相关.FRAX和股骨颈（FN）BMD之间没有一致性。所测试的自身抗体均未与FN骨质减少或骨质疏松症相关，包括高水平的IgMRF。
■我们的研究强调了定量测量自身抗体在评估RA患者骨折风险中的重要性。我们的初步发现需要在前瞻性研究中进行评估，以确定RA患者中高IgMRF水平的实际预测价值。
