Abstract
OBJECTIVES--To determine whether there was a generalised increase in bone mineral density (BMD) in spinal osteoarthrosis (OA), and to determine the mechanism of this possible protection against osteoporosis as assessed by biochemical markers of bone turnover. METHODS--We studied 375 women (ages 50 to 85) from a population based group. Spinal OA was defined from radiographs as the presence of degenerative changes affecting intervertebral or facet joints. BMD of the lumbar spine (LS), femoral neck (FN) and total body (TB) was measured by dual energy x ray absorptiometry (Lunar DPX). Bone turnover rates were estimated from measurement of biochemical markers of bone formation and resorption (urine deoxypyridinoline (Dpyr) and serum bone specific alkaline phosphatase (BAP)). RESULTS--BMD at each site was greater in the women with spinal OA (mean increase in LS-BMD 7.9%, 95% confidence interval (CI) 1.0 to 15.1; TB-BMD 8.4%, 95% CI 1.9 to 9.7; FN-BMD 6.4%, 95% CI 0.3 to 12.6). Twenty four hour urinary excretion of Dpyr, corrected for TB bone mineral content, and serum BAP were 19% lower in the women with spinal OA (95% CI for Dpyr 4.3 to 31.9%; for BAP 6.3 to 32.0%). CONCLUSIONS--Spinal OA is associated with a generalised increase in BMD and a decreased rate of bone turnover. This suggests that the protective effect of spinal OA against osteoporosis may be mediated by decreased bone turnover.
Full text
PDFSelected References
These references are in PubMed. This may not be the complete list of references from this article.
- Astbury C., Bird H. A., McLaren A. M., Robins S. P. Urinary excretion of pyridinium crosslinks of collagen correlated with joint damage in arthritis. Br J Rheumatol. 1994 Jan;33(1):11–15. doi: 10.1093/rheumatology/33.1.11. [DOI] [PubMed] [Google Scholar]
- Belmonte-Serrano M. A., Bloch D. A., Lane N. E., Michel B. E., Fries J. F. The relationship between spinal and peripheral osteoarthritis and bone density measurements. J Rheumatol. 1993 Jun;20(6):1005–1013. [PubMed] [Google Scholar]
- Colwell A., Russell R. G., Eastell R. Factors affecting the assay of urinary 3-hydroxy pyridinium crosslinks of collagen as markers of bone resorption. Eur J Clin Invest. 1993 Jun;23(6):341–349. doi: 10.1111/j.1365-2362.1993.tb02034.x. [DOI] [PubMed] [Google Scholar]
- Cooper C., Cook P. L., Osmond C., Fisher L., Cawley M. I. Osteoarthritis of the hip and osteoporosis of the proximal femur. Ann Rheum Dis. 1991 Aug;50(8):540–542. doi: 10.1136/ard.50.8.540. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Cooper C., Poll V., McLaren M., Daunt S. O., Cawley M. I. Alterations in appendicular skeletal mass in patients with rheumatoid, psoriatic, and osteoarthropathy. Ann Rheum Dis. 1988 Jun;47(6):481–484. doi: 10.1136/ard.47.6.481. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Dequeker J. The relationship between osteoporosis and osteoarthritis. Clin Rheum Dis. 1985 Aug;11(2):271–296. [PubMed] [Google Scholar]
- Eastell R., Cedel S. L., Wahner H. W., Riggs B. L., Melton L. J., 3rd Classification of vertebral fractures. J Bone Miner Res. 1991 Mar;6(3):207–215. doi: 10.1002/jbmr.5650060302. [DOI] [PubMed] [Google Scholar]
- Hordon L. D., Wright V., Smith M. A. Bone mass in osteoarthritis. Ann Rheum Dis. 1992 Jun;51(6):823–825. doi: 10.1136/ard.51.6.823. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Knight S. M., Ring E. F., Bhalla A. K. Bone mineral density and osteoarthritis. Ann Rheum Dis. 1992 Sep;51(9):1025–1026. doi: 10.1136/ard.51.9.1025. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Lawrence J. S., Bremner J. M., Bier F. Osteo-arthrosis. Prevalence in the population and relationship between symptoms and x-ray changes. Ann Rheum Dis. 1966 Jan;25(1):1–24. [PMC free article] [PubMed] [Google Scholar]
- MacDonald A. G., McHenry P., Robins S. P., Reid D. M. Relationship of urinary pyridinium crosslinks to disease extent and activity in osteoarthritis. Br J Rheumatol. 1994 Jan;33(1):16–19. doi: 10.1093/rheumatology/33.1.16. [DOI] [PubMed] [Google Scholar]
- Masud T., Langley S., Wiltshire P., Doyle D. V., Spector T. D. Effect of spinal osteophytosis on bone mineral density measurements in vertebral osteoporosis. BMJ. 1993 Jul 17;307(6897):172–173. doi: 10.1136/bmj.307.6897.172. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Orwoll E. S., Oviatt S. K., Mann T. The impact of osteophytic and vascular calcifications on vertebral mineral density measurements in men. J Clin Endocrinol Metab. 1990 Apr;70(4):1202–1207. doi: 10.1210/jcem-70-4-1202. [DOI] [PubMed] [Google Scholar]
- Price T., Hesp R., Mitchell R. Bone density in generalized osteoarthritis. J Rheumatol. 1987 Jun;14(3):560–562. [PubMed] [Google Scholar]
- Reid I. R., Evans M. C., Ames R., Wattie D. J. The influence of osteophytes and aortic calcification on spinal mineral density in postmenopausal women. J Clin Endocrinol Metab. 1991 Jun;72(6):1372–1374. doi: 10.1210/jcem-72-6-1372. [DOI] [PubMed] [Google Scholar]
- Rosalki S. B., Foo A. Y. Two new methods for separating and quantifying bone and liver alkaline phosphatase isoenzymes in plasma. Clin Chem. 1984 Jul;30(7):1182–1186. [PubMed] [Google Scholar]
- Ross P. D., Davis J. W., Epstein R. S., Wasnich R. D. Pre-existing fractures and bone mass predict vertebral fracture incidence in women. Ann Intern Med. 1991 Jun 1;114(11):919–923. doi: 10.7326/0003-4819-114-11-919. [DOI] [PubMed] [Google Scholar]
- Seibel M. J., Duncan A., Robins S. P. Urinary hydroxy-pyridinium crosslinks provide indices of cartilage and bone involvement in arthritic diseases. J Rheumatol. 1989 Jul;16(7):964–970. [PubMed] [Google Scholar]
- Thompson P. W., Spector T. D., James I. T., Henderson E., Hart D. J. Urinary collagen crosslinks reflect the radiographic severity of knee osteoarthritis. Br J Rheumatol. 1992 Nov;31(11):759–761. doi: 10.1093/rheumatology/31.11.759. [DOI] [PubMed] [Google Scholar]