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Osteocalcin in patients with rheumatoid arthritis . A one-year followup study . OBJECTIVE To analyze clinical , radiological , and drug ( disease modifying antirheumatic drug , DMARD ) dependent factors influencing bone turnover in patients with rheumatoid arthritis ( RA ) . METHODS We investigated in a one-year double blind randomized study comparing intramuscular ( im ) gold with im methotrexate ( MTX ) , whether the variation of inflammatory activity or functional capacity , the ascending anatomic stage , or DMARD treatments have an influence on bone formation ( osteocalcin ) in patients with RA . RESULTS Patients ( n = 48 ) enrolled at the beginning of our study had significantly increased osteocalcin levels ( 3.45 +/- 0.93 -- > 4.42 +/- 1.39 ng/ml p < 0.02 ) after one year if inflammatory activity decreased ( > or = 1 SD : erythrocyte sedimentation rate ( ESR ) 26.4 mm/h , C-reactive protein ( CRP ) 3.8 mg/dl ) . We found a significant negative correlation of the one-year CRP- ( r = -0.44 , p < 0.001 ) or ESR differences ( r = -0.45 , p < 0.001 ) with the corresponding osteocalcin differences . This was also evident if these patients were pooled with 15 patients excluded from the double blind study as already receiving DMARD treatment ( n = 63 ; p < 0.01 ) . Patients with impaired functional capacity also had significantly reduced osteocalcin levels ( p < 0.01 ) . In both cases , alkaline phosphatase showed no significant differences . CONCLUSIONS Our data suggest that osteocalcin , a useful followup variable of bone turnover , is changed significantly ( p < 0.02 ) in patients with RA regarding inflammatory activity and functional capacity . In contrast to alkaline phosphatase , a fall in inflammatory activity stimulated and impairment of functional capacity significantly decreased osteocalcin levels in patients with RA .
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Intervention_Pharmacological
Osteocalcin
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Intervention_Pharmacological
intramuscular ( im ) gold with im methotrexate ( MTX )
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Intervention_Pharmacological
DMARD treatment
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Outcome_Physical
inflammatory activity
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Outcome_Physical
functional capacity
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Outcome_Other
osteocalcin levels
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Outcome_Physical
inflammatory activity
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Outcome_Physical
erythrocyte sedimentation rate ( ESR )
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Outcome_Physical
C-reactive protein ( CRP )
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Outcome_Physical
CRP-
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Outcome_Physical
ESR
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Outcome_Other
differences
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Outcome_Physical
functional capacity
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Outcome_Physical
osteocalcin levels
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Outcome_Other
alkaline phosphatase
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Outcome_Physical
bone turnover
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Outcome_Physical
inflammatory activity
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Outcome_Physical
functional capacity
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Outcome_Other
alkaline phosphatase
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Outcome_Physical
functional capacity
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Participant_Condition
rheumatoid arthritis
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Participant_Condition
rheumatoid arthritis ( RA )
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Participant_Sample-size
48
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Participant_Condition
RA
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Participant_Condition
RA