The Roles Of The Bone Metabolism Markers Such As TRACP-5、CTX-、BALP On Bone Destruction Of Psoriatic Arthritis

Part OneObjective:To observe the bone metabolism of PsA and explore the changes of the bone metabolism markers such as TRACP5,CTX-Ⅰ and BALP in the PsA patients with bone destruction.Method:65cases of psoriatic arthritis,30cases of psoriasis and30cases of helthy people from Huashan Hospital were enrolled during January2010and December2010. The PsA patients’bone mineral densities were measured for the lumbar spines and the left femoral necks using dual energy x-ray absorptiometry. Serum levels of TRACP5b、CTX-Ⅰ、BALP of healthy controls,Ps and PsA patients were measured by ELISA respectively and analyzed by SPSS. Devide the PsA group into bone destruction group and none bone destruction group by image datasets. The level of TRACP5b,CTX-Ⅰ,BALP, PsAJAI, ESR and CRP were compared between two groups.Results:Among65cases of psoriatic arthritis, sex ratio of male to female was2.3:1with45males and20females, the average age was47.58±13.4years old. The course of skin lesion was6to600months, the average course was165.23±136.7months; and the course of arthritis was0.2to312months, and the average course was57.33±73.4months.The levels of TRACP5b of the healthy controls,Ps and PsA patients were0.87±0.4U/L,0.70±0.5U/L and2.03±1.4U/L,and the levels of TRACP5b were significantly higher in PsA patients than other two groups(p<0.05). The levels of CTX-Ⅰ of the healthy controls,Ps and PsA patients were0.91±0.8ng/mL,0.63±0.67ng/mL and2.63±1.8ng/mL,and the levels of CTX-Ⅰ were dramatically higher in PsA patients than other two groups(p<0.05). The levels of BALP of the healthy controls,Ps and PsA patients were21.91±4.3U/L,22.07±4.3U/L and25.14±6.8U/L,and the levels of BALP were obviously higher in PsA patients than other two groups (p<0.05). The levels of TRACP5b(2.59±1.4U/L),CTX-Ⅰ (3.08±1.8ng/mL) and BALP (26.52±7.1U/L) were significantly higher in bone destruction group than in none bone destruction group (1.18±1.0U/L,1.90±1.6ng/mL,23.08±5.7U/L, p<0.05).Conclusion:The higher levels of TRACP5b,CTX-Ⅰ and BALP in PsA indicate the bone metabolism imbalances in PsA. The higher levels of TRACP5b,CTX-Ⅰ and BALP in bone destruction group indicate that the rises of TRACP5,CTX-Ⅰ and BALP levels were related with bone erosion. Part TwoObjective:to explore the relation of the bone metabolism markers such as TRACP5b, CTX-Ⅰ and BALP with the disease activities in PsA.Method:33PsA from Huashan Hospital during January2010and December2010patients were enrolled in. Devide the PsA group into bone destruction group and none bone destruction group by image datasets. All patients were treated by methotrexate for at least3months. All patients serum levels of TRACP5b,CTX-Ⅰ and BALP were measured before and after the treatment in the3th month. Analyse the correlation of TRACP5b,CTX-Ⅰ and BALP with PsAJA,ESR and CRP.Results:The levels of PsAJAI in patients with erosion were13.7±6.2and10.3±7.5before and after the treatment,those in patients without erosin were6.0±2.4and5.0±1.7;the levels of ESR in two groups were78.2±84.2mm/h and33.6±23.1mm/h,33.6±23.0mm/h and20.1±13.9mm/h; the levels of CRP were48.1±50.6mg/L and12.8±12.6mg/L,16.6±17.4mg/L and8.8±8.2mg/L;the levels of TRACP5b were2.61±1.3U/L,2.26±1.1U/L and1.10±0.9U/L,0.88±0.5U/L;the levels of CTX-Ⅰ were3.40±1.6ng/mL,2.17±1.9ng/mL and1.26±0.6ng/mL,0.80±0.2ng/mL;the levels of BALP were26.31±3.2U/L,21.21±2.2U/L and22.21±2.2U/L,19.28±1.8U/L,and there were statistical differences in every group after treatment except for the the levels of TRACP5b in none bone destruction group. There was positive correlationship between TRACP5b,CTX-Ⅰ and PsAJAI (r=0.52and p=0.003, r=0.64and p=0.0002). There was no correlationship between BALP and PsAJAI(r=0.08and p=0.2968). There was positive correlationship between CTX-Ⅰ and ESR(r=0.51and p=0.0026),but there was no correlationship between TRACP5b,BALP and ESR(r=0.20and p=0.2575, r=0.26and p=0.1407). Otherwise, there was no correlationship between TRACP5b, CTX-Ⅰ,BALP and CRP(r=0.11and p=0.5435, r=0.34and p=0.0534, r=0.26and p=0.1467).Conclusion:The levels of ESR,CPR,PsAJAI, TRACP5b,CTX-Ⅰ and BALP decreased after treatment in both two groups. There was positive correlationship between TRACP5b, CTX-Ⅰ and PsAJAI,but there was no correlationship between BALP and PsAJAI. We can judge the disease activities and bone destruction of PsA patients using the three bone metabolism markers.