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. 1989 Jun;48(6):483–487. doi: 10.1136/ard.48.6.483

Reduced bone formation in non-steroid treated patients with rheumatoid arthritis.

J E Compston 1, S Vedi 1, R W Mellish 1, P Croucher 1, M M O'Sullivan 1
PMCID: PMC1003792  PMID: 2742402

Abstract

The cellular basis of trabecular bone loss in rheumatoid arthritis was investigated in 45 non-steroid treated patients. Mean wall thickness, an indicator of the amount of bone formed per remodelling unit, mean interstitial bone thickness, which is related to resorption depth, and the extent of trabecular surface covered by osteoid, which reflects the number of remodelling units, were assessed in iliac crest biopsy specimens. The mean wall thickness was significantly reduced in the patient group when compared with controls matched for age and sex (mean (SD) 39.8 (5.4) v 51.6 (9.7) microns). There was no significant difference between patients and controls in the mean interstitial bone thickness (51.0 (26.4) v 61.4 (31.9) microns) or osteoid surface (16.7 (11.4) v 21.0 (10.5)%). These results show that reduced bone formation at the remodelling unit level is the predominant mechanism of bone loss in rheumatoid arthritis.

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Selected References

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  1. Als O. S., Christiansen C., Hellesen C. Prevalence of decreased bone mass in rheumatoid arthritis. Relation to anti-inflammatory treatment. Clin Rheumatol. 1984 Jun;3(2):201–208. doi: 10.1007/BF02030755. [DOI] [PubMed] [Google Scholar]
  2. Bjelle A. O., Nilsson B. E. Osteoporosis in rheumatoid arthritis. Calcif Tissue Res. 1970;5(4):327–332. doi: 10.1007/BF02017562. [DOI] [PubMed] [Google Scholar]
  3. Castillo B. A., el Sallab R. A., Scott J. T. Physical activity, cystic erosions, and osteoporosis in rheumatoid arthritis. Ann Rheum Dis. 1965 Nov;24(6):522–527. doi: 10.1136/ard.24.6.522. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Dempster D. W., Arlot M. A., Meunier P. J. Mean wall thickness and formation periods of trabecular bone packets in corticosteroid-induced osteoporosis. Calcif Tissue Int. 1983 Jul;35(4-5):410–417. doi: 10.1007/BF02405069. [DOI] [PubMed] [Google Scholar]
  5. Duncan H., Frost H. M., Villanueva A. R., Sigler J. W. The osteoporosis of rheumatoid arthritis. Arthritis Rheum. 1965 Oct;8(5):943–954. doi: 10.1002/art.1780080504. [DOI] [PubMed] [Google Scholar]
  6. Eriksen E. F. Normal and pathological remodeling of human trabecular bone: three dimensional reconstruction of the remodeling sequence in normals and in metabolic bone disease. Endocr Rev. 1986 Nov;7(4):379–408. doi: 10.1210/edrv-7-4-379. [DOI] [PubMed] [Google Scholar]
  7. Gevers G., Devos P., De Roo M., Dequeker J. Increased levels of osteocalcin (serum bone Gla-protein) in rheumatoid arthritis. Br J Rheumatol. 1986 Aug;25(3):260–262. doi: 10.1093/rheumatology/25.3.260. [DOI] [PubMed] [Google Scholar]
  8. Hancock D. A., Asiedu-Offei S., Atkinson P. J., Reed G. W., Wright V. Femoral bone mass in patients with rheumatoid arthritis and osteoarthrosis. Rheumatol Rehabil. 1978 May;17(2):65–71. doi: 10.1093/rheumatology/17.2.65. [DOI] [PubMed] [Google Scholar]
  9. Heaney R. P., Walch J. J., Steffes P., Skillman T. G. Periarticular bone remodeling in rheumatoid arthritis. Calcif Tissue Res. 1968;(Suppl):33–33b. doi: 10.1007/BF02065215. [DOI] [PubMed] [Google Scholar]
  10. Hooyman J. R., Melton L. J., 3rd, Nelson A. M., O'Fallon W. M., Riggs B. L. Fractures after rheumatoid arthritis. A population-based study. Arthritis Rheum. 1984 Dec;27(12):1353–1361. doi: 10.1002/art.1780271205. [DOI] [PubMed] [Google Scholar]
  11. Lips P., Courpron P., Meunier P. J. Mean wall thickness of trabecular bone packets in the human iliac crest: changes with age. Calcif Tissue Res. 1978 Nov 10;26(1):13–17. doi: 10.1007/BF02013227. [DOI] [PubMed] [Google Scholar]
  12. Mellish R. W., O'Sullivan M. M., Garrahan N. J., Compston J. E. Iliac crest trabecular bone mass and structure in patients with non-steroid treated rheumatoid arthritis. Ann Rheum Dis. 1987 Nov;46(11):830–836. doi: 10.1136/ard.46.11.830. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Minaire P., Neunier P., Edouard C., Bernard J., Courpron P., Bourret J. Quantitative histological data on disuse osteoporosis: comparison with biological data. Calcif Tissue Res. 1974;17(1):57–73. doi: 10.1007/BF02547214. [DOI] [PubMed] [Google Scholar]
  14. Mueller M. N., Jurist J. M. Skeletal status in rheumatoid arthritis. A preliminary report. Arthritis Rheum. 1973 Jan-Feb;16(1):66–70. doi: 10.1002/art.1780160110. [DOI] [PubMed] [Google Scholar]
  15. Ng K. C., Revell P. A., Beer M., Boucher B. J., Cohen R. D., Currey H. L. Incidence of metabolic bone disease in rheumatoid arthritis and osteoarthritis. Ann Rheum Dis. 1984 Jun;43(3):370–377. doi: 10.1136/ard.43.3.370. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Oka M., Rekonen A., Kuikka J., Anttinen J. Bone mineral density in rheumatoid arthritis measured by the gamma transmission method. Scand J Rheumatol. 1975;4(1):28–32. [PubMed] [Google Scholar]
  17. Ramser J. R., Duncan H., Landeros O., Epker B., Frost H. M. Measurements of bone dynamics in seven patients with salicylate-treated rheumatoid arthritis. Arthritis Rheum. 1966 Jun;9(3):424–429. doi: 10.1002/art.1780090307. [DOI] [PubMed] [Google Scholar]
  18. Reid D. M., Kennedy N. S., Smith M. A., Tothill P., Nuki G. Total body calcium in rheumatoid arthritis: effects of disease activity and corticosteroid treatment. Br Med J (Clin Res Ed) 1982 Jul 31;285(6338):330–332. doi: 10.1136/bmj.285.6338.330. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Rosenspire K. C., Kennedy A. C., Steinbach J., Blau M., Green F. A. Investigation of the metabolic acitivity of bone in rheumatoid arthritis. J Rheumatol. 1980 Jul-Aug;7(4):469–473. [PubMed] [Google Scholar]
  20. Sambrook P. N., Ansell B. M., Foster S., Gumpel J. M., Hesp R., Reeve J., Zanelli J. M. Bone turnover in early rheumatoid arthritis. 1. Biochemical and kinetic indexes. Ann Rheum Dis. 1985 Sep;44(9):575–579. doi: 10.1136/ard.44.9.575. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Saville P. D., Kharmosh O. Osteoporosis of rheumatoid arthritis: influence of age, sex and corticosteroids. Arthritis Rheum. 1967 Oct;10(5):423–430. doi: 10.1002/art.1780100504. [DOI] [PubMed] [Google Scholar]
  22. Vedi S., Compston J. E., Webb A., Tighe J. R. Histomorphometric analysis of bone biopsies from the iliac crest of normal British subjects. Metab Bone Dis Relat Res. 1982;4(4):231–236. doi: 10.1016/0221-8747(82)90032-7. [DOI] [PubMed] [Google Scholar]
  23. Verstraeten A., Dequeker J. Vertebral and peripheral bone mineral content and fracture incidence in postmenopausal patients with rheumatoid arthritis: effect of low dose corticosteroids. Ann Rheum Dis. 1986 Oct;45(10):852–857. doi: 10.1136/ard.45.10.852. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Virtama P., Helelä T., Kalliomäki J. L. Osteoporosis in rheumatoid arthritis. A follow-up study. Acta Rheumatol Scand. 1968;14(4):276–284. doi: 10.3109/rhe1.1968.14.issue-1-4.30. [DOI] [PubMed] [Google Scholar]
  25. Wordsworth B. P., Vipond S., Woods C. G., Mowat A. G. Metabolic bone disease among in-patients with rheumatoid arthritis. Br J Rheumatol. 1984 Nov;23(4):251–257. doi: 10.1093/rheumatology/23.4.251. [DOI] [PubMed] [Google Scholar]

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