Skip to main content

Advertisement

SpringerLink
Log in

Osteoporosis and Osteoarthritis, Rheumatoid Arthritis and Spondylarthropathies

  • Epidemiology and Pathophysiology (RA Adler, Section Editor)
  • Published:
Current Osteoporosis Reports Aims and scope Submit manuscript

Abstract

Osteoporosis (OP) commonly occurs in the setting of inflammatory arthritis, whereas there is an inverse relationship with osteoarthritis (OA). We review the recent updates in epidemiology and pathophysiology of OP relating to several arthridities. In ankylosing spondylitis, lateral lumbar spine dual x-ray absorptiometry is better at detecting osteoporosis compared with the AP view and patients receiving treatment with anti- tumor necrosis factor medications had lower levels of bone turnover markers. With regard to rheumatoid arthritis, anticitrullinated peptide positivity without clinical arthritis as well as higher levels of interleukin-6 is associated with decreased bone mineral density and polymorphisms in the vitamin D receptor in RA patients may predispose to OP. With regard to OA, results from the Global Longitudinal Study of Osteoporosis in Women study and several radiological studies suggest that differences in the distribution of bone mass at the femoral neck may account for the inverse relationship of OA and OP, and several studies suggest that OA and OP have opposing cytokine and bone metabolism marker profiles.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

Papers of particular interests, published recently, have been highlighted as •• Of major importance

  1. •• Redlich K, Smolen JS. Inflammatory bone loss: pathogenesis and therapeutic intervention. Nat Rev Drug Discov. 2012;11(3):234–50. Reviews the pathogenesis of bone loss in chronic inflammatory disease and how this relates to current therapies.

  2. Cauley JA, Fullman RL, Stone KL, et al. Factors associated with the lumbar spine and proximal femur bone mineral density in older men. Osteoporos Int. 2005;16:1525–37.

    Article  PubMed  Google Scholar 

  3. Vestergaard P, Rejnmark L, Mosekilde L. Osteoarthritis and risk of fractures. Calcif Tissue Int. 2009;84:249–56.

    Article  PubMed  CAS  Google Scholar 

  4. Van der Weijden MAC, Claushuis TAM, Nazari T, et al. High prevalence of low bone mineral density in patients within 10 years of onset of ankylosing spondylitis: a systematic review. Clin Rheumatol. 2012;31:1529–35.

    Article  PubMed  Google Scholar 

  5. Kilngberg E, Lorentzon M, Mellstrom D, et al. Osteoporosis in ankylosing spondylitis- prevalence, risk factors and methods of assessment. Arthritis Res Ther. 2012;14:108–20.

    Article  Google Scholar 

  6. Klingberg E, Geijer M, Gothlin J, et al. Vertebral fractures in ankylosing spondylitis are associated with lower bone mineral density in both central and peripheral skeleton. J Rheumatol. 2012;39(10):1987–95.

    Article  PubMed  Google Scholar 

  7. Grazio S, Kusic Z, Cvijetic S, et al. Relationship of bone mineral density with disease activity and functional ability in patients with ankylosing spondylitis: a cross sectional study. Rheumatol Int. 2012;32(9):2801–8.

    Article  PubMed  CAS  Google Scholar 

  8. Taylan A, Sari I, Akinci B, et al. Biomarkers and cytokines of bone turnover: extensive evaluation in a cohort of patients with ankylosing spondylitis. BMC Musculoskelet Disord. 2012;13:191–8.

    Article  PubMed  CAS  Google Scholar 

  9. Ibanez M, Ortiz AM, Castrejon I, et al. A rational use of glucocorticoids in patients with early arthritis has a minimal impact on bone mass. Arthritis Res Ther. 2010;12:R50.

    Article  PubMed  Google Scholar 

  10. Lee SG, Park YE, Park SH, et al. Increased frequency of osteoporosis and BMD below the expected range for age among South Korean women with RA. Int J Rheum Dis. 2012;15(3):289–96.

    Article  PubMed  Google Scholar 

  11. Harre U, Georgess D, Bang H, et al. Intriduction of osteoclastogenesis and bone loss by human autoantibodies against citrullinated vimentin. J Clin Invest. 2012;122:1791–802.

    Article  PubMed  CAS  Google Scholar 

  12. Kleyer A, Finzel S, Rech J, et al. Bone loss before the clinical onset of rheumatoid arthritis in subjects with anticitrullinated protein antibodies. Ann Rheum Dis. 2013. doi: 10.1136/annrheumdis-2012-202958.

  13. Ghazi M, Kolta S, Briot K, et al. Prevalence of vertebral fractures in patients with rheumatoid arthritis: revisiting the role of glucocorticoid. Osteoporos Int. 2012;23(2):581–7.

    Article  PubMed  CAS  Google Scholar 

  14. Henderson NK, Sambrook PN. Relationship between osteoporosis and arthritis and effect of corticosteroids and other drugs on bone. Curr Opin Rheumatol. 1996;8:365–9.

    Article  PubMed  CAS  Google Scholar 

  15. Di Munno O, Mazzantini M, Sinigaglia L. Effect of low dose methotrexate on bone density in women with rheumatoid arthritis: results from a multi-center cross-sectional study. J Rheumatol. 2004;31(7):1305–9.

    PubMed  Google Scholar 

  16. Seriolo B, Paolino S, Sulli A, Ferretti V, Cutolo M. Bone metabolism changes during anti-TNF-alpha therapy in patients with active rheumatoid arthritis. Ann NY Acad Sci. 2006;1069:420–7.

    Article  PubMed  CAS  Google Scholar 

  17. Barnabe C, Hanley D. Effect of tumor necrosis factor alpha inhibition on bone density and turnover markers in patients with rheumatoid arthritis and spondyloarthropathy. Semin Arthritis Rheum. 2009;39:116–22.

    Article  PubMed  CAS  Google Scholar 

  18. Torikai E, Kageyama Y, Takahashi M, et al. The effect of infliximab on bone metabolism markers in patients with rheumatoid arthritis. Rheumatology. 2006;45:761–4.

    Article  PubMed  CAS  Google Scholar 

  19. Wijbrandts CA, Klassen R, Dijkgraaf MG, et al. Bone mineral density in rheumatoid arthritis patients 1 year after adalimumab therapy: arrest of bone loss. Ann Rheum Dis. 2009;68(3):373–6.

    Article  PubMed  CAS  Google Scholar 

  20. Kim SY, Schneeweiss S, Liu J, et al. Effects of disease-modifying antirheumatic drugs on nonvertebral fracture risk in rheumatoid arthritis: a population based cohort study. J Bone Miner Res. 2012;27(4):789–96.

    Google Scholar 

  21. Moon SJ, Ahn IE, Kwok SK, et al. Periarticular osteoporosis is a prominent feature in early rheumatoid arthritis: estimation using shaft to periarticular bone mineral density ratio. J Korean Med Sci. 2013;28(2):287–94.

    Article  PubMed  Google Scholar 

  22. Xu S, Want Y, Lu J, Xu J. Osteoprotegerin and RANKL in the pathogenesis of rheumatoid arthritis- induced osteoporosis. Rheumatol Int. 2012;32(11):3397–403.

    Article  PubMed  CAS  Google Scholar 

  23. Hofbauer LC, Lacey DL, Dunstan CR, Spelsberg TC, Riggs BL, Khosla S. Interleukin-1beta and tumor necrosis factor alpha, but not interleukin-6 stimulate osteoprotegerin ligand gene expression in human osteolastic cells. Bone. 1999;25:255–9.

    Article  PubMed  CAS  Google Scholar 

  24. Rose-John S, Scheller J, Elson G, Jones SA. Interleukin-6 biology is coordinated by membrane-bound and soluble receptors: role in inflammation and cancer. J Leukoc Biol. 2006;80:227–36.

    Article  PubMed  CAS  Google Scholar 

  25. Oelzner P, Franke S, Lehmann G, et al. The balance between soluble receptors regulating IL-6 trans-signaling is predictive for the RANKL/osteoprotegerin ration in postmenopausal women with RA. 2012;32(1):199–206.

  26. Caetano-Lopes J, Rodrigues A, Lopes A, et al. Rheumatoid arthritis bone fragility is associated with upregulation of IL17 and DKK1 gene expression. Clin Rev Allergy Immunol. 2013. doi: 10.1007/s12016-013-8366-y.

  27. Gjesdal CG, Vollset SE, Ueland UG, et al. Plasma homocysteine, folate, and vitamin B 12 and the risk of hip fracture: the Hordaland Homocysteine study. J Bone Miner Res. 2007;22:747–56.

    Article  PubMed  CAS  Google Scholar 

  28. Brambila-Tapia AJ, Duran-Gonzalez J, Sandoval-Ramirez L, et al. MTHFR C677T, MTHFR A1298C, and OPG A163G polymorphisms in Mexican patients with rheumatoid arthritis and osteoporosis. Dis Markers. 2013;32(2):109–14.

    Article  Google Scholar 

  29. Hussein YM, Shehata A, Karam RA, et al. Polymorphism in vitamin D receptor and osteoprotegerin genes in Egyptian rheumatoid arthritis patients with and without osteoporosis. Mol Biol Rep. 2013;40(5):3675–80.

    Article  Google Scholar 

  30. Hochberg MC, Meyer JM. Bone disease in rheumatology. Baltimore, MD:Lippincott Williams and Wilkins; 2005.

  31. Dennison EM, Compston JE, Flahive J. Effect of co-morbidities on fracture risk: findings from the Global Longitudinal study of Osteoporosis in Women (GLOW). Bone. 2012;50(6):1288–93.

    Article  PubMed  Google Scholar 

  32. Prieto-Alhambra D, Nogues X, Javaid MK, et al. An increased rate of falling leads to a rise in fracture risk in postmenopausal women with self-reported osteoarthritis: a prospective multinational cohort study (GLOW). Ann Rheum Dis. 2013;72(6):911–7.

    Article  PubMed  Google Scholar 

  33. Castaño-Betancourt MC, Rivadeneira F, Bierma-Zeinstra S, et al. Bone parameters across different types of hip osteoarthritis and their relationship to osteoporotic fracture risk. Arthritis Rheum. 2013;65(3):693–700.

    Article  PubMed  Google Scholar 

  34. Rubinacci A, Resoldi D, Scalco E, et al. Comparative high resolution pQCT analysis of femoral neck indicates different bone mass distribution in osteoporosis and osteoarthritis. Osteoporos Int. 2012;23(7):1967–75.

    Article  PubMed  CAS  Google Scholar 

  35. Zupan J, Van’t Hof RJ, Vindisar F, et al. Osteoarthritis vs osteoporotic bone and intra-skeletal variations in normal bone: evaluation with micro-CT and bone histomorphometry. J Orthop Res. 2013;31(7):1059–66.

    Article  PubMed  Google Scholar 

  36. Chiba K, Uetani M, Kido Y, et al. Osteoporotic changes of subchondral trabecular bone in osteoarthritis of the knee: a 3-T MRI study. Osteoporos Int. 2013;23(2):589–97.

    Article  Google Scholar 

  37. Giner M, Montoya MJ, Vazquez MA, Miranda C, Perez-Cano R. Differences in osteogenic and apoptotic genes between osteoporotic and osteoarthritis patients. BMC Musculoskelet Disord. 2013;13:41.

    Article  Google Scholar 

  38. Delgado-Calle J, Fernandez AF, Sainz J. Genome-wide profiling of bone reveals differentially methylated regions in osteoporosis and osteoarthritis. Arthritis Rheum. 2013;65(1):197–205.

    Article  PubMed  CAS  Google Scholar 

  39. Zupan J, Komadina R, Marc J. The relationship between osteoclastogenic and anti-osteoclastogenic pro-inflammatory cytokines differs in human osteoporotic and osteoarthritic bone tissues. J Biomed Sci. 2012;19:28–34.

    Article  PubMed  CAS  Google Scholar 

  40. Corrado A, Neve A, Macchiarola A, et al. RANKL/OPG ratio and DKK-1 expression in primary osteoblastic cultures from osteoarthritis and osteoporotic subjects. J Rheumatol. 2013;40(5):684–94.

    Article  PubMed  CAS  Google Scholar 

Download references

Compliance with Ethics Guidelines

Conflict of Interest

EK Smelter declares that she has no conflicts of interest. MC Hochberg declares that he has no conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Author information

Authors and Affiliations

  1. Division of Rheumatology and Clinical Immunology, Department of Medicine, University of Maryland School of Medicine and Medical Service, Veterans Affairs Maryland Health Care System, 10 S. Pine St., MSTF 8-34, Baltimore, MD, 21201, USA

    Elizabeth Smelter Clayton & Marc C. Hochberg

Authors
  1. Elizabeth Smelter Clayton
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Marc C. Hochberg
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Elizabeth Smelter Clayton.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Clayton, E.S., Hochberg, M.C. Osteoporosis and Osteoarthritis, Rheumatoid Arthritis and Spondylarthropathies. Curr Osteoporos Rep 11, 257–262 (2013). https://doi.org/10.1007/s11914-013-0172-1

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11914-013-0172-1

Keywords

Search

Navigation