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Rheumatology Advance Access published online on October 11, 2005
Rheumatology, doi:10.1093/rheumatology/kei045
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© The Author 2005. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oupjournals.org
Received June 14, 2005
Accepted July 12, 2005

Concise Report

Low bone density and low serum levels of soluble RANK ligand are associated with severe arterial calcification in patients with Takayasu arteritis

M. C. Bezerra 1, G. D. Calomeni 1, V. F. Caparbo 1, E. S. Gebrim 2, M. S. Rocha 2, and R. M. R. Pereira 1*

1 Division of Rheumatology, School of Medicine, University of São Paulo, São Paulo, Brazil
2 Division of Radiology, School of Medicine, University of São Paulo, São Paulo, Brazil

* To whom correspondence should be addressed.
R. M. R. Pereira, E-mail: rosamariarp{at}yahoo.com


  Abstract

Objective. Takayasu arteritis (TA) is a chronic inflammatory disorder affecting the aorta and its branches. Vascular calcification has been described in 29-54% of cases of TA, although its aetiology remains unknown. Recently the osteoprotegerin/RANKL/RANK system has emerged as an important contributing factor to atherogenesis and osteogenesis. Our aim is to investigate the association between vascular calcification, bone mineral density (BMD) and the osteoprotegerin/RANK/RANKL system in TA.

Methods. Thirty pre-menopausal female TA patients and 30 age- and sex-matched controls were studied. BMD was measured by dual X-ray absorptiometry. Arterial calcification in TA patients was analysed by computed tomography in thoracic and abdominal sites. Serum levels of osteoprotegerin and soluble receptor activator of nuclear factor {kappa}B ligand (sRANKL) were quantified by enzyme-linked immunosorbent assay.

Results. Patients with severe arterial calcification showed lower BMD values than controls in lumbar spine (0.965 ± 0.055 vs 1.126 ± 0.153 g/cm2, P = 0.009) and total body (0.993 ± 0.065 vs 1.085 ± 0.082 g/cm2, P = 0.019). In contrast, TA patients without calcification presented BMD values similar to controls (P>0.05). Interestingly, lower serum levels of sRANKL (1.89 ± 2.35 vs 2.80 ± 2.23 pg/ml, P = 0.031) and a longer disease duration (12.20 ± 6.61 vs 3.56 ± 5.33 yr, P = 0.004) were observed in TA patients with severe calcification compared with patients without calcification.

Conclusions. Severe arterial calcification in TA is associated with low values of BMD and sRANKL, reinforcing the possible link between bone and vascular disease.

Keywords: Takayasu arteritis; Bone mineral density; sRANKL; Arterial calcification.
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