Osteocalcin in Patients with Rheumatoid Arthritis in One-year Followup Study-Effect of Functional Stages, Inflammatory Activity and Therapy

類風濕性關節炎患者血清骨鈣素測定一年追蹤研究－功能等級，發炎活動度，和治療之影響

黃春明(Chung-Ming Huang) ； 周昌德(Chung-Tei Chou) ； 林彩秀(Sai-Hsiu Lin) ； 王秀娟(Hsiu-Jain Wang)

《Mid-Taiwan Journal of Medicine》 3卷2期 (1998/06) Pp. 82-87

https://doi.org/10.6558/MTJM.1998.3(2).3

摘要

類風濕性關節炎患者易造成骨質疏鬆是我們所熟知，但造成骨質流失之原因和機轉仍不十分清楚。骨鈣素是骨頭代謝之指標並可反應骨頭生成。我們用前瞻性方法以一年時間，探討類風濕性關節炎患者血清骨鈣素濃度是否因發炎活動度，功能等級和DMARD藥物治療之改變而變化。共有28位類風濕性關節炎患者納入本研究。經過一年治療，我們發現血清骨鈣素濃度有統計上之增加（1.48±0.96→2.18±1.88 ng/mL，＂p＂＜0.05）。然而，在發炎指數ESR（≧39 mm/h）或CRP（≧3.9 mg/dL）上升一個標準值之病人，其血清骨鈣素濃度並沒有統計上之改變。同樣地，在發炎指數ESR或CRP下降一個標準值之病人，其血清骨鈣素濃度也沒有統計上之增加。另外，我們發現ESR和CRP之變化和血清骨鈣素濃度之變化沒有相關性。我們資料顯示血清骨鈣素濃度在一年DMARD治療後有明顯統計上之增加，可作為骨頭轉化之有效指數，但是，血清骨鈣素濃度似乎和功能上等級和發炎活動力沒有相關聯。

關鍵字

類風濕性關節炎 ； 骨鈣素 ； 發炎活動力 ； 功能上等級 ； 治療

並列摘要

It is well known that patients with rheumatoid arthritis (RA) have osteopenia. The etiology and the mechanisms producing this bone loss are poorly understood. Osteocalcin (OC) is a marker for bone metabolism and reflects bone formation. We investigated in a one-year prospective study whether the serum OC concentrations in patients with RA was significantly changed with the variation of inflammatory activity, functional stages, or disease modifying antirheumatic drug (DMARD) treatments. Twenty-eight RA patients was enrolled in this prospective study. After a one-year treatment, we could demonstrate a statistical increase in OC values (1.48±0.96→2.18±1.88 ng/mL, p ＜0.05). However, no significant differences in serum OC concentrations in patients who showed a fall in erythrocyte sedimentation rate (ESR) (≧1SD: 39 mm/h) or C reactive protein (CRP) (≧1SD: 3.9 mg/dL) were observed. Likewise, OC values of patients without such changes of inflammatory activity (ESR or CRP＜1SD) did not increase. We found no correlation of ESR differences and CRP differences with OC differences. Our data suggested that OC levels, a useful follow-up variable of bone turnover, increased significantly after one year of DMARD treatment. This seemed, however, not to be associated with functional stages and inflammatory activity in patients with RA.

並列關鍵字

rheumatoid arthritis ； osteocalcin ； inflammatory activity ； functional stages ； treatment