Differential expression of bone metabolism biomarkers in various types of arthritis and their diagnostic performance: a cross-sectional study

Abstract

Background: Bone metabolism markers have shown significant potential for diagnosis and prognosis in arthritis. This study aims to evaluate expression levels of bone metabolism markers in various types of arthritis and their diagnostic value.

Methods: This study included 1,838 participants, comprising 919 arthritis patients (Rheumatoid Arthritis (RA), Systemic Osteoarthritis (SO), Gouty Arthritis (GA), and Ankylosing Spondylitis (AS)) and 919 healthy controls, treated at our hospital from July 2019 to February 2022. Data were collected on demographics, bone metabolism markers and inflammatory markers. Correlation analysis was performed between inflammatory factors and bone metabolism markers. ROC curve analysis was conducted to assess the diagnostic performance of these markers.

Results: There was no significant demographic difference. All inflammatory markers were elevated in the arthritis group (P < 0.001). Bone formation markers (N-MID, Total-P1NP, OC, BSAP) were lower, and bone resorption markers (β-CrossLaps, CTX-I) were higher in the arthritis group (P < 0.001). Significant correlations were found between inflammatory and bone metabolism markers (P < 0.01). ROC analysis showed OC had the highest diagnostic accuracy in SO (AUC = 0.948), BSAP in GA (AUC = 0.803), and RA (AUC = 0.906), and OC in AS (AUC = 0.747).

Conclusion: This study highlights the diagnostic value of bone metabolism markers in distinguishing arthritis subtypes, revealing their correlation with inflammatory markers.

Keywords: Arthritis; Bone metabolism markers; Diagnosis; Prognosis.