Relationship between bone mineral density and anti- citrullinated protein antibody and rheumatoid factor in patients with rheumatoid arthritis

Abstract

Objective: Rheumatoid arthritis (RA) is one of the causes of osteoporosis, and it leads to systemic boneloss. The anti-citrullinated protein antibody (ACPA) and rheumatoid factor (RF) are associated with lo-cal and systemic low bone mineral density and osteoclast-mediated bone resorption independentlyof inflammation in patients with RA. In this article, we aimed to evaluate the relationship between theACPA, RF, and systemic bone mineral density in patients with RA.Methods: Ninety-three patients (6 male, 87 female) with RA were included in the study. The disease ac-tivity score 28-erythrocyte sedimentation rate and titers of RF, ACPA, and bone mineral density of thetotal hip, femoral neck, and lumbar areas were evaluated. The independent samples t-test, Mann-WhitneyU-test, Spearman’s correlation, and multivariable regression analysis were used for the statistical analysis.Results: The RF and ACPA were positive in 40.9% and 48.4% of patients with RA, respectively. Diseaseactivity was negatively correlated with the T- and Z-scores. The T- and Z-scores were lower in the se-ropositive group than in the seronegative group. The ACPA was negatively correlated with the T- andZ-scores of the femoral neck. There was a significant difference for the Z-score of the femoral neck inpatients with ACPA and RF-positive patients compared to seronegative patients with RA.Conclusion: A low bone mineral density, especially in the femoral neck, is associated with the pres-ence of ACPA and RF. It would be a more appropriate approach to carefully monitor osteoporosis inseropositive RA patients.