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대한류마티스학회> Journal of Rheumatic Diseases(구 대한류마티스학회지)> Rheumatoid Factor Positivity is Associated with Lower Bone Mass in Korean Male Health Examinees without Clinically Apparent Arthritis

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Rheumatoid Factor Positivity is Associated with Lower Bone Mass in Korean Male Health Examinees without Clinically Apparent Arthritis

Jiwon Hwang , Joong Kyong Ahn , Jaejoon Lee , Eun-mi Koh , Hoon-suk Cha
  • : 대한류마티스학회
  • : Journal of Rheumatic Diseases(구 대한류마티스학회지) 26권1호
  • : 연속간행물
  • : 2019년 01월
  • : 31-41(11pages)
피인용수 : 35건

(자료제공: 네이버학술정보)

DOI


목차

INTRODUCTION
MATERIALS AND METHODS
RESULTS
DISCUSSION
CONCLUSION
ACKNOWLEDGMENTS
CONFLICT OF INTEREST
SUPPLEMENTARY DATA
REFERENCES

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Objective. This cross-sectional study aimed to investigate the association between rheumatoid factor (RF) positivity and bone mineral density (BMD) in male Korean subjects without any history of joint disease. Methods. Of 84,344 males who had undergone a comprehensive health checkup program in 2012, 1,390 male health examinees were recruited, whose BMD and RF results were available. A RF titer ≥20 IU/mL was considered positive. BMD was measured at lumbar spine (L1∼L4) or hip (femoral neck and total hip) by dual-energy X-ray absorptiometry. Results. The association between RF positivity and BMD was assessed by multiple linear regression analysis. The mean age was 52.7±10.9 years (range 19∼88 years), and RF was detected in 64 subjects (4.6%). Demographics and laboratory data were not different between RF-positive and -negative subjects except hepatitis B surface antigen (HBsAg), which was more frequently seen in RF-positive subjects (15.6% vs. 4.3%, p=0.001). RF-positive subjects had significantly lower BMD compared to RF-negative subjects in lumbar spine but not in total hip regardless of the existence of HBsAg (1.17±0.16 g/㎠ vs. 1.10±0.18 g/㎠, p=0.002 in total subjects; 1.17±0.16 g/㎠ vs. 1.10±0.18 g/㎠, p=0.004 in HBsAg-negative subjects). After adjusting for multiple confounders, RF positivity was negatively associated with lumbar spine BMD (B=-0.088 and standard error=0.035, p=0.011). Conclusion. Our results show that the presence of RF could have an unfavorable impact on bone density in apparently normal males. Additional studies to elucidate the osteoimmunological mechanism of rheumatoid factor are warranted. (J Rheum Dis 2019;26:31-40)

ECN


UCI

간행물정보

  • : 의약학분야  > 정형외과학
  • : KCI 등재
  • : -
  • : 격월
  • : 2093-940X
  • :
  • : 학술지
  • : 연속간행물
  • : 1994-2019
  • : 1296


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1Early Detection of Pulmonary Hypertension in Connective Tissue Disease

저자 : Chan Hong Jeon

발행기관 : 대한류마티스학회 간행물 : Journal of Rheumatic Diseases(구 대한류마티스학회지) 26권 1호 발행 연도 : 2019 페이지 : pp. 1-4 (4 pages)

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2Normality Test in Clinical Research

저자 : Sang Gyu Kwak , Sung-hoon Park

발행기관 : 대한류마티스학회 간행물 : Journal of Rheumatic Diseases(구 대한류마티스학회지) 26권 1호 발행 연도 : 2019 페이지 : pp. 5-11 (7 pages)

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In data analysis, given that various statistical methods assume that the distribution of the population data is normal distribution, it is essential to check and test whether or not the data satisfy the normality requirement. Although the analytical methods vary depending on whether or not the normality is satisfied, inconsistent results might be obtained depending on the analysis method used. In many clinical research papers, the results are presented and interpreted without checking or testing normality. According to the central limit theorem, the distribution of the sample mean satisfies the normal distribution when the number of samples is above 30. However, in many clinical studies, due to cost and time restrictions during data collection, the number of samples is frequently lower than 30. In this case, a proper statistical analysis method is required to determine whether or not the normality is satisfied by performing a normality test. In this regard, this paper discusses the normality check, several methods of normality test, and several statistical analysis methods with or without normality checks. (J Rheum Dis 2019;26:5-11)

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Rheumatoid arthritis (RA) is a chronic inflammatory disease of multifactorial etiology. Smoking is considered one of the most established environmental risk factors for RA development and severity. A large proportion of patients with RA have a high prevalence of smoking history. Previous studies have provided evidence suggesting that smoking is associated with the development of RA. Smoking has been associated with several pathogenic mechanisms on RA development such as oxidative stress, inflammation, and epigenetic changes. There is a need for public health campaigns to educate the public regarding these risks and preventive measures that reduce smoking are essential and may result in a decline in RA incidence. Encouragement of smoking cessation is especially warranted in relatives of patients with RA. Recently, RA-specific smoking cessation interventions have been developed. This review will summarize the knowledge accumulated to date concerning associations between smoking and RA. (J Rheum Dis 2019;26:12-19)

4Effectiveness and Safety of Tacrolimus in Patients with Active Rheumatoid Arthritis with Inadequate Response to Disease-modifying Anti-rheumatic Drugs: The TREASURE Study

저자 : Dong Hyuk Sheen , Seung Jae Hong , Sang Heon Lee , Hye Soon Lee , Won Tae Chung , Hongsi Jiang , Sungmin Lee , Dae Hyun Yoo

발행기관 : 대한류마티스학회 간행물 : Journal of Rheumatic Diseases(구 대한류마티스학회지) 26권 1호 발행 연도 : 2019 페이지 : pp. 20-30 (11 pages)

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Objective. Evaluate effectiveness/safety of tacrolimus in patients in Korea with active rheumatoid arthritis (RA) and unsuccessful response to disease-modifying anti-rheumatic drugs (DMARDs). Methods. Open-label, single-arm, non-comparative, 24-week, Phase-IV study in patients with active RA who had taken DMARDs for >6 months. Following a washout period, tacrolimus was initiated (baseline-12 weeks; dose 2 mg/day and 1.5 mg/day in patients aged ≤65 and >65 years, respectively). After 12 weeks, dose could be adjusted (remaining between 1~3 mg); treatment continued to 24 weeks. Primary endpoint was American College of Rheumatology 20% improvement (ACR20) (baseline-Week 24). Secondary endpoints included ACR50/ACR70 response, disease-activity score in 28 joints (DAS28) erythrocyte sedimentation rate (ESR), number of tender/ swollen joints, and bone mineral density (BMD) loss. Adverse events (AEs) were recorded. Results. Overall, 121 patients were analysed. Mean ±standard deviation tacrolimus dose baseline-Week 24 was 1.81±0.47 mg/day. After 24 weeks, 64.5%, 39.7%, and 19.0% of patients were ACR20, ACR50, and ACR70 responders, respectively. DAS28-ESR score decreased from 5.5±0.8 (baseline) to 3.7±1.5 (Week 24; p<0.0001); number of tender/swollen joints decreased. Between screening and Week 24, change in BMD-T score in lumbar and femur regions was -0.06±0.38 (p=0.1550) and -0.04±0.28 (p=0.0936), respectively, with no significant change in International Society for Clinical Densitometry classification. Fifty-six (46.3%) patients experienced 93 AEs; 75.3% were mild. No unexpected safety signals identified. Conclusion. Tacrolimus therapy was associated with a high proportion of ACR responders, and improved DAS28-ESR score and physical joint function during the study. Tacrolimus may be a suitable therapy for DMARD-resistant patients with RA. (J Rheum Dis 2019;26:20-30)

5Rheumatoid Factor Positivity is Associated with Lower Bone Mass in Korean Male Health Examinees without Clinically Apparent Arthritis

저자 : Jiwon Hwang , Joong Kyong Ahn , Jaejoon Lee , Eun-mi Koh , Hoon-suk Cha

발행기관 : 대한류마티스학회 간행물 : Journal of Rheumatic Diseases(구 대한류마티스학회지) 26권 1호 발행 연도 : 2019 페이지 : pp. 31-41 (11 pages)

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Objective. This cross-sectional study aimed to investigate the association between rheumatoid factor (RF) positivity and bone mineral density (BMD) in male Korean subjects without any history of joint disease. Methods. Of 84,344 males who had undergone a comprehensive health checkup program in 2012, 1,390 male health examinees were recruited, whose BMD and RF results were available. A RF titer ≥20 IU/mL was considered positive. BMD was measured at lumbar spine (L1∼L4) or hip (femoral neck and total hip) by dual-energy X-ray absorptiometry. Results. The association between RF positivity and BMD was assessed by multiple linear regression analysis. The mean age was 52.7±10.9 years (range 19∼88 years), and RF was detected in 64 subjects (4.6%). Demographics and laboratory data were not different between RF-positive and -negative subjects except hepatitis B surface antigen (HBsAg), which was more frequently seen in RF-positive subjects (15.6% vs. 4.3%, p=0.001). RF-positive subjects had significantly lower BMD compared to RF-negative subjects in lumbar spine but not in total hip regardless of the existence of HBsAg (1.17±0.16 g/㎠ vs. 1.10±0.18 g/㎠, p=0.002 in total subjects; 1.17±0.16 g/㎠ vs. 1.10±0.18 g/㎠, p=0.004 in HBsAg-negative subjects). After adjusting for multiple confounders, RF positivity was negatively associated with lumbar spine BMD (B=-0.088 and standard error=0.035, p=0.011). Conclusion. Our results show that the presence of RF could have an unfavorable impact on bone density in apparently normal males. Additional studies to elucidate the osteoimmunological mechanism of rheumatoid factor are warranted. (J Rheum Dis 2019;26:31-40)

6Fate of Abstracts Presented at the Korean College of Rheumatology Annual Scientific Meetings

저자 : Yong-gil Kim , Chan-bum Choi , Seong Wook Kang , Jinseok Kim , Young Dae Kim , Jaejoon Lee , Myeung Su Lee , Young-ho Lee , Jun-ki Min , Min-chan Park , Sung Hoon Park , Yong-wook Park , Seung Wook Lee ,

발행기관 : 대한류마티스학회 간행물 : Journal of Rheumatic Diseases(구 대한류마티스학회지) 26권 1호 발행 연도 : 2019 페이지 : pp. 41-45 (5 pages)

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Objective. To evaluate the fate of abstracts presented at scientific meetings of the Korean College of Rheumatology (KCR). Methods. This study examined the abstracts presented at annual meetings of the KCR from 2005 to 2014. Only original studies were selected, excluding case reports. A manual search was conducted using PubMed, KoreaMed, Cochrane Library, and Embase to track the published articles. The abstracts were considered to have been published if the authors, title, study design, and results were the same for a published article. In addition, they were considered published if the author and the study design matched, even if the results of the abstract and the results of the published articles were not identical. Results. A total of 928 abstracts from 2005 to 2014 were analyzed. Of the 928 abstracts, 468 (50.43%) abstracts were published in a peer-reviewed journal and the mean time to publication was 19 months. Of the 468 abstracts, 414 were published in a science citation index extended (SCI[E]) journal, and 54 were published in non-SCI(E) journals. The proportion of SCI(E) articles increased annually. The average impact factor for the SCI(E) journals was 2.93. In subgroup analysis, the abstracts that were awarded the best oral or best poster presentation were more likely to be published as full-length articles with a higher impact factor than the abstracts not awarded. Conclusion. Half of the abstracts presented in the KCR annual meetings were published in a peer-reviewed journal. Approximately 90% of the articles were published in a SCI(E) journal. (J Rheum Dis 2019;26:41-45)

7Distinct Urinary Metabolic Profile in Rheumatoid Arthritis Patients: A Possible Link between Diet and Arthritis Phenotype

저자 : Jung Hee Koh , Yune-jung Park , Saseong Lee , Young-shick Hong , Kwan Soo Hong , Seung-ah Yoo , Chul-soo Cho , Wan-uk Kim

발행기관 : 대한류마티스학회 간행물 : Journal of Rheumatic Diseases(구 대한류마티스학회지) 26권 1호 발행 연도 : 2019 페이지 : pp. 46-58 (13 pages)

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Objective. We undertook this study to investigate the discriminant metabolites in urine from patients with established rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and from healthy individuals. Methods. Urine samples were collected from 148 RA patients, 41 SLE patients and 104 healthy participants. The urinary metabolomic profiles were assessed using 1H nuclear magnetic resonance spectroscopy. The relationships between discriminant metabolites and clinical variables were assessed. Collagen-induced arthritis was induced in mice to determine if a choline-rich diet reduces arthritis progression. Results. The urinary metabolic fingerprint of patients with established RA differs from that of healthy controls and SLE patients. Markers of altered gut microbiota (trimethylamine-N-oxide, TMAO), and oxidative stress (dimethylamine) were upregulated in patients with RA. In contrast, markers of mitochondrial dysfunction (citrate and succinate) and metabolic waste products (p-cresol sulfate, p-CS) were downregulated in patients with RA. TMAO and dimethylamine were negatively associated with serum inflammatory markers in RA patients. In particular, patients with lower p-CS levels exhibited a more rapid radiographic progression over two years than did those with higher p-CS levels. The in vivo functional study demonstrated that mice fed with 1% choline, a source of TMAO experienced a less severe form of collagen-induced arthritis than did those fed a control diet. Conclusion. Patients with RA showed a distinct urinary metabolomics pattern. Urinary metabolites can reflect a pattern indicative of inflammation and accelerated radiographic progression of RA. A choline-rich diet reduces experimentally-induced arthritis. This finding suggests that the interaction between diet and the intestinal microbiota contributes to the RA phenotype. (J Rheum Dis 2019;26:46-56)

8Comparison of Renal Responses to Cyclophosphamide and Mycophenolate Mofetil used as Induction Therapies in Korean Patients with Lupus Nephritis

저자 : Sung-eun Choi , Dong-jin Park , Ji-hyoun Kang , Kyung-eun Lee , Haimuzi Xu , Ji Shin Lee , Yoo-duk Choi , Shin-seok Lee

발행기관 : 대한류마티스학회 간행물 : Journal of Rheumatic Diseases(구 대한류마티스학회지) 26권 1호 발행 연도 : 2019 페이지 : pp. 57-65 (9 pages)

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Objective. Although intravenous cyclophosphamide (IVC) is generally accepted as the standard therapy for induction treatment of active proliferative lupus nephritis (LN), several clinical trials have suggested that mycophenolate mofetil (MMF) is at least as effective as IVC. Because few Asian studies have compared the two treatment modalities, we compared the efficacies of MMF and IVC as LN remission induction treatments in Korean patients. Methods. We enrolled 39 patients with class III and IV LN who received MMF or IVC as LN induction therapy. The renal outcomes (i.e., complete response [CR], partial response [PR], and no response [NR]) at 6 and 12 months were defined using the ACR 2006 response criteria. Results. Of 39 patients, 23 (59.0%) were treated with IVC, and 16 (41.0%) were treated with MMF. Demographics, clinical characteristics, laboratory data, and adverse events did not significantly differ between the two groups. However, C3 levels were lower and activity scores in renal biopsy were higher in IVC-treated patients. CRs were achieved by 11 (47.8%) of the patients receiving IVC and 7 (43.8%) of the patients receiving MMF after 6 months of treatment (p=0.961) and by 11 (47.8%) of those who received IVC and 9 (56.2%) of those who received MMF at 12 months of treatment (p=0.713). Neither the PR rate nor the NR rate differed significantly at 6 or 12 months between the two groups. Conclusion. The efficacy of MMF does not differ from that of IVC in terms of induction of LN remission in Korean patients. (J Rheum Dis 2019;26:57-65)

9Endoscopic Features of Upper Gastrointestinal Tract in Patients with Systemic Sclerosis Compared to the Healthy Control

저자 : Jun Won Park , Jihye Kim , Eun Ae Kang , Min Jung Kim , Joo Sung Kim , Eun Bong Lee

발행기관 : 대한류마티스학회 간행물 : Journal of Rheumatic Diseases(구 대한류마티스학회지) 26권 1호 발행 연도 : 2019 페이지 : pp. 66-77 (12 pages)

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Objective. To characterize the endoscopic features of upper gastrointestinal tract in patients with systemic sclerosis (SSc) compared with those in the healthy controls. Methods. Data on esophagogastroduodenoscopy (EGD) in 180 patients with SSc (SSc group) were compared with that from the 181 age- and sex-matched healthy control who underwent EGD for routine check-up (control group). Clinical data of participants at the time of EGD (defined as baseline) were collected from electric medical record. Endoscopic findings were evaluated by two experts with blinded to their clinical features. Primary outcome of the study was prevalence of each endoscopic lesion between the two groups. Results. The mean±standard deviation age and disease duration in the SSc group at baseline were 55.3±11.8 and 2.9±3.7 years, respectively. Compared to the control group, SSc group more frequently showed reflux esophagitis (32.8% vs. 9.4%, p<0.001). In contrast, prevalence of atrophic gastritis was significantly lower in the SSc group (8.3% vs. 29.3%, p<0.001). This result was consistent in the multivariable analysis where patients' age and concomitant proton pump inhibitor use were adjusted. There was no case of gastric antral vascular ectasia (GAVE) in both groups. However, 29 (16.1%) patients in SSc group showed a clinically significant anemia (hemoglobin <10 mg/dL), with none of the endoscopic features showed significant associations with the outcome. Conclusion. Patients with SSc showed significantly lower prevalence of atrophic gastritis. There was no case of GAVE, which suggests that clinical phenotype of the SSc could be different according to the ethnicity or geographic region. (J Rheum Dis 2019;26:66-73)

10Catastrophic Antiphospholipid Syndrome Associated with Systemic Lupus Erythematosus Successfully Treated with Rituximab: A Case Report

저자 : Jinshik Shin , Kwang Nam Kim

발행기관 : 대한류마티스학회 간행물 : Journal of Rheumatic Diseases(구 대한류마티스학회지) 26권 1호 발행 연도 : 2019 페이지 : pp. 74-78 (5 pages)

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The catastrophic variant of antiphospholipid syndrome (APS) is a very rare and life-threatening condition of APS. This condition is characterized by thrombosis in multiple organs within a short period of time in the presence of positive antiphospholipid antibodies (aPL). Over the past few decades, considerable progress has been made in the treatment of patients with catastrophic APS; however, the mortality rate still remains very high. Although some cases of rituximab treatment in patients with catastrophic APS have been reported, there is no clear treatment protocol. A 14-year-old girl with systemic lupus erythematosus was diagnosed with catastrophic APS. She received several medications: corticosteroids, intravenous immunoglobulin, and plasmapheresis with anticoagulants. Unfortunately, she did not improve, and rituximab was started with four courses. After the rituximab treatment, she did not experience further thrombotic events during the follow up. This paper reports a pediatric case of catastrophic APS treated successfully with rituximab in Korea. (J Rheum Dis 2019;26:74-78)

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