Biochemical markers of bone turnover in seronegative spondylarthropathy: relationship to disease activity |
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Authors: | MacDonald AG; Birkinshaw G; Durham B; Bucknall RC; Fraser WD |
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Institution: | Department of Rheumatology, Royal Liverpool University Hospital. |
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Abstract: | To investigate bone turnover in patients with seronegative
spondylarthropathy, a bone formation marker, type 1 procollagen carboxy-
terminal propeptide (P1CP), and resorption markers, the pyridinium
cross-links of collagen urinary free (f) PYR and DPYR], were measured. The
median f-PYR, f-DPYR and P1CP (+/-interquartile range) were 15.8 (6.00)
nmol/mmol creatinine, 3.8 (2.2) nmol/mmol creatinine and 101.5 (38)
micrograms/1, respectively. There was a positive correlation between
resorption markers and acute-phase reactants such as C-reactive protein (r
= 0.42 for PYR, r = 0.42 for DPYR, P < 0.05), and a negative correlation
observed between P1CP and the erythrocyte sedimentation rate (r = -0.64, P
< 0.05). In the subgroup of patients with an elevated CRP concentration,
the concentration of PYR and DPYR was significantly increased (f-PYR 25.7
vs 15.8 and f-DPYR 6.6 vs 3.8, P < 0.01 for f-PYR, P < 0.05 for
f-DPYR). This study suggests than an elevation in acute-phase response in
patients with seronegative spondylarthropathy is associated with increased
concentration of bone resorption markers with a tendency for reduction in
bone formation markers. This may represent uncoupling of bone formation and
resorption, leading to bone loss in such patients.
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