Structural mechanisms of bone loss in iliac biopsies: comparison between rheumatoid arthritis and postmenopausal osteoporosis

Abstract To assess the mechanisms that cause generalized osteoporosis in rheumatoid arthritis (RA), 40 postmenopausal women with RA (46–74 years) and 40 age-matched controls with osteopenia underwent iliac bone biopsies. A structural analysis of histomorphometry and two-dimensional strut analysis were performed As compared to those with primary osteoporosis, there were a few unique characteristics in those with RA. Trabecular thickness and wall thickness declined with age, and this decline was especially accelerated by glucocorticoids. Decreased connectivity of the trabecular (Nd.Nd) was more prominent than the disappearance of the nodes. The connectivity of cortical bone to the nodes (Ct.Nd) and cortical thickness significantly decreased with age. With glucocorticoid therapy, the disappearance of the nodes was accelerated. In the case of vertebral compression fractures, the parameters of Nd.Nd and Ct.Nd significantly decreased. Although a bone biopsy is needed to analyze strut, this method is useful to evaluate the quality or intensity of the bone.

[1]  H W Wahner,et al.  Changes in bone mineral density of the proximal femur and spine with aging. Differences between the postmenopausal and senile osteoporosis syndromes. , 1982, The Journal of clinical investigation.

[2]  A. Parfitt.  Bone histomorphometry: standardization of nomenclature, symbols and units (summary of proposed system). , 1988, Bone.

[3]  M. Kleerekoper,et al.  Relationships between surface, volume, and thickness of iliac trabecular bone in aging and in osteoporosis. Implications for the microanatomic and cellular mechanisms of bone loss. , 1983, The Journal of clinical investigation.

[4]  R. Recker,et al.  Static and tetracycline‐based bone histomorphometric data from 34 normal postmenopausal females , 1988, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[5]  J. Dayer,et al.  Inhibition of the production and effects of interleukin-1 and tumor necrosis factor alpha in rheumatoid arthritis. , 1995, Arthritis and rheumatism.

[6]  J. Compston,et al.  A new method for the two‐dimensional analysis of bone structure in human iliac crest biopsies , 1986, Journal of microscopy.

[7]  R. Thompson,et al.  Interleukin-1 receptor antagonist decreases bone loss and bone resorption in ovariectomized rats. , 1994, The Journal of clinical investigation.

[8]  H K Genant,et al.  Quantitative computed tomography for prediction of vertebral fracture risk. , 1985, Bone.

[9]  M. Liang,et al.  The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. , 1988, Arthritis and rheumatism.

[10]  F. Melsen,et al.  Reconstruction of the resorptive site in iliac trabecular bone: a kinetic model for bone resorption in 20 normal individuals. , 1984, Metabolic bone disease & related research.

[11]  P. Bordier,et al.  Quantitative histology of metabolic bone disease , 1972 .

[12]  G V Cochran,et al.  A new manual method for assessing two‐dimensional cancellous bone structure: Comparison between iliac crest and lumbar vertebra , 1991, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[13]  T. Hirano,et al.  Excessive production of interleukin 6/B cell stimulatory factor‐2 in rheumatoid arthritis , 1988, European journal of immunology.

[14]  H. Broxmeyer,et al.  Increased osteoclast development after estrogen loss: mediation by interleukin-6. , 1992, Science.