THU0139 Increased homocysteine level for 7 years in patients with rheumatoid arthritis: tomorrow study. (12th June 2018)

• Record Type: Journal Article
• Authors: Inui, K.; Koike, T.; Sugioka, Y.; Okano, T.; Mamoto, K.; Yamada, Y.; Mandai, K.; Tada, M.; Nakamura, H.
• Is Part Of: Annals of the rheumatic diseases. Volume 77(2018)Supplement 2
• Page Start: 289
• Page End: 290
• Publication Date: 2018-06-12
• Subjects: Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2018-eular.1439
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Background: Osteoporosis is a disease in which not only bone density but also bone quality is low. Patients with rheumatoid arthritis (RA) are at higher proven risk of osteoporosis. Increased homocysteine (Hcy), one of the main markers of bone quality, is caused by insufficiency of folate or vitamin B. Elevation of Hcy inhibits physiological crosslink of collagen, which yields worse bone quality. Objectives: In this study, we evaluated Hcy level as a bone quality marker in patients with RA for a period of 7 years and compared Hcy in RA patients with that in healthy volunteers (Vo). Methods: We used the data for 7 years from a prospective cohort study (TOMORROW Study: UMIN000003876), which started in 2010 and compares data from RA patients with age- and sex-matched volunteer controls (Vo) recruited through mass media. Laboratory data were collected for all participants, including bone metabolic markers (urinary pentosidine, Hcy, collagen type 1 crosslinked N-telopeptide (NTX), and osteocalcin) and anthropometric parameters. Bone mineral density (BMD) of the lower leg was determined using whole-body dual-energy X-ray absorptiometry (DXA). Their parameters were compared with those of healthy controls, and multiple regression analysis was carried out only in the RA population. In RA patients, treatment regimen and Disease Activity Score 28 were recorded. Results: There were 413 participants (208 RA patients and 205 in the Vo group; mean age, 58 years) enrolled in the study, 349 of whom were female. In RA patients (mean disease duration, 13 years), bone density was significantly lower (p<0.001. repeated-measures ANOVA) and Hcy (p<0.0001, repeated-measures ANOVA) was higher in comparison with the Vo group during the 7 year study period. In the analysis of change in Hcy level over 7 years, "RA" and "time" were found to interact with each other (p=2.58e-7, repeated-measures ANOVA) (figure 1). Multiple linear regression analysis in the RA population revealed a relationship between the level of Hcy and MTX dose at baseline (p=0.048), but no relationship between the level of Hcy and MCV (p=0.165). Conclusions: MTX intake leads to folate deficiency, which is thought to cause elevation of the Hcy level. Ageing is another significant factor related to Hcy increase. Acknowledgements: We thank Atsuko Kamiyama and Tomoko Nakatsuka for serving as research coordinators in terms of recruiting participants, collecting data and managing the quality of the data. Disclosure of Interest: None declared