THE EFFECTS OF MENOPAUSAL STATUS AND DISEASE-ACTIVITY ON BIOCHEMICAL MARKERS OF BONE METABOLISM IN FEMALE-PATIENTS WITH RHEUMATOID-ARTHRITIS

The effects of menopause and disease activity on bone metabolism in rh eumatoid arthritis (RA) were studied by using biochemical markers of b one metabolism. We measured osteocalcin, bone-specific alkaline phosph alase, urinary total pyridinoline and deoxypyridinoline, and urinary f ree deoxypyridinoline in 78 female patients with RA (39 pre-menopause, Pre-PA, 39 postmenopause, Post-RA) and 53 female normal controls (28 pre-menopause, Pre-NC; 26 post-menopause, Post-NC). In Pre-PA, althoug h bone formation was equal to Pre-NC, bone resorption increased. In Po st-PA, however, bone formation was lower while bone resorption was hig her than in Post-NC. The high disease activity RA group showed higher bone turnover than the low disease activity RA group. We conclude that menopause affects the bone turnover in RA as well as in normal contro ls. In Pre-PA, osteopenia is caused by the increase in bone resorption . In Post-PA, osteopenia is caused by the increase in uncoupling betwe en bone formation and bone resorption. Furthermore, the high disease a ctivity of RA induces high bone turnover.