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Arthritis Research & Therapy
Published in: Arthritis Research & Therapy 1/2019

Open Access 01-12-2019 | Systemic Lupus Erythematosus | Review

Common mechanisms and holistic care in atherosclerosis and osteoporosis

Authors: Zoltán Szekanecz, Hennie G. Raterman, Zsófia Pethő, Willem F. Lems

Published in: Arthritis Research & Therapy | Issue 1/2019

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Abstract

Cardiovascular (CV) disease and osteoporosis (OP) have become increasing challenges in the aging population and even more in patients with inflammatory rheumatic diseases, such as rheumatoid arthritis, spondyloarthropathies, and systemic lupus erythematosus. In this review, we discuss how the epidemiology and pathogenesis of CV events and OP are overlapping. Smoking, diabetes mellitus, physical inactivity as conventional risk factors as well as systemic inflammation are among the modifiable risk factors for both CV events and bone loss. In rheumatic patients, systemic “high-grade” inflammation may be the primary driver of accelerated atherogenesis and bone resorption. In the general population, in which some individuals might have low-grade systemic inflammation, a holistic approach to drug treatment and lifestyle modifications may have beneficial effects on the bone as well as the vasculature. In rheumatic patients with accelerated inflammatory atherosclerosis and bone loss, the rapid and effective suppression of inflammation in a treat-to-target regime, aiming at clinical remission, is necessary to effectively control comorbidities.
Literature
1.
Radner H, Yoshida K, Smolen JS, Solomon DH. Multimorbidity and rheumatic conditions-enhancing the concept of comorbidity. Nat Rev Rheumatol. 2014;10:252–6.PubMedCrossRef
2.
Barnett K, Mercer SW, Norbury M, Watt G, Wyke S, Guthrie B. Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study. Lancet. 2012;380:37–43.PubMedCrossRef
3.
Prabhakaran D, Anand S, Watkins D, Gaziano T, Wu Y, Mbanya JC, Disease Control Priorities-3 Cardiovascular R, Related Disorders Author G, et al. Cardiovascular, respiratory, and related disorders: key messages from Disease Control Priorities, 3rd edition. Lancet. 2018;391:1224–36.PubMedCrossRef
4.
Agca R, Heslinga SC, Rollefstad S, Heslinga M, McInnes IB, Peters MJ, et al. EULAR recommendations for cardiovascular disease risk management in patients with rheumatoid arthritis and other forms of inflammatory joint disorders: 2015/2016 update. Ann Rheum Dis. 2017;76:17–28.PubMedCrossRef
5.
Szekanecz Z, Kerekes G, Vegh E, Kardos Z, Barath Z, Tamasi L, et al. Autoimmune atherosclerosis in 3D: How it develops, how to diagnose and what to do. Autoimmun Rev. 2016;15:756–69.PubMedCrossRef
6.
Szentpetery A, Horvath A, Gulyas K, Petho Z, Bhattoa HP, Szanto S, et al. Effects of targeted therapies on the bone in arthritides. Autoimmun Rev. 2017;16:313–20.PubMedCrossRef
7.
Salman-Monte TC, Torrente-Segarra V, Vega-Vidal AL, Corzo P, Castro-Dominguez F, Ojeda F, et al. Bone mineral density and vitamin D status in systemic lupus erythematosus (SLE): A systematic review. Autoimmun Rev. 2017;16:1155–9.PubMedCrossRef
8.
9.
Lems WF, Dreinhofer KE, Bischoff-Ferrari H, Blauth M, Czerwinski E, da Silva J, et al. EULAR/EFORT recommendations for management of patients older than 50 years with a fragility fracture and prevention of subsequent fractures. Ann Rheum Dis. 2017;76:802–10.PubMedCrossRef
10.
Lems WF, Raterman HG. Critical issues and current challenges in osteoporosis and fracture prevention. An overview of unmet needs. Ther Adv Musculoskelet Dis. 2017;9:299–316.PubMedPubMedCentralCrossRef
11.
Nurmohamed MT, Heslinga M, Kitas GD. Cardiovascular comorbidity in rheumatic diseases. Nat Rev Rheumatol. 2015;11:693–704.PubMedCrossRef
12.
Shoenfeld Y, Gerli R, Doria A, Matsuura E, Cerinic MM, Ronda N, et al. Accelerated atherosclerosis in autoimmune rheumatic diseases. Circulation. 2005;112:3337–47.PubMedCrossRef
13.
Dougados M, Soubrier M, Antunez A, Balint P, Balsa A, Buch MH, et al. Prevalence of comorbidities in rheumatoid arthritis and evaluation of their monitoring: results of an international, cross-sectional study (COMORA). Ann Rheum Dis. 2014;73:62–8.PubMedCrossRef
14.
Ramsey-Goldman R, Manzi S. Association of osteoporosis and cardiovascular disease in women with systemic lupus erythematosus. Arthritis Rheum. 2001;44:2338–41.PubMedCrossRef
15.
Symmons DP, Gabriel SE. Epidemiology of CVD in rheumatic disease, with a focus on RA and SLE. Nat Rev Rheumatol. 2011;7:399–408.PubMedCrossRef
16.
17.
Szekanecz Z, Kerekes G, Kardos Z, Baráth Z, Tamási L. Mechanisms of inflammatory atherosclerosis in rheumatoid arthritis. Curr Immunol Rev. 2016;12:35–46.CrossRef
18.
19.
Szekanecz Z, Kerekes G, Soltesz P. Vascular effects of biologic agents in RA and spondyloarthropathies. Nat Rev Rheumatol. 2009;5:677–84.PubMedCrossRef
20.
McFarlane SI, Muniyappa R, Shin JJ, Bahtiyar G, Sowers JR. Osteoporosis and cardiovascular disease: brittle bones and boned arteries, is there a link? Endocrine. 2004;23:1–10.PubMedCrossRef
21.
Laroche M, Pecourneau V, Blain H, Breuil V, Chapurlat R, Cortet B, et al. Osteoporosis and ischemic cardiovascular disease. Joint Bone Spine. 2017;84:427–32.PubMedCrossRef
22.
Laakso M, Kuusisto J. Epidemiological evidence for the association of hyperglycaemia and atherosclerotic vascular disease in non-insulin-dependent diabetes mellitus. Ann Med. 1996;28:415–8.PubMedCrossRef
23.
Napoli N, Chandran M, Pierroz DD, Abrahamsen B, Schwartz AV, Ferrari SL, et al. Mechanisms of diabetes mellitus-induced bone fragility. Nat Rev Endocrinol. 2017;13:208–19.PubMedCrossRef
24.
Lampropoulos CE, Papaioannou I, D’Cruz DP. Osteoporosis--a risk factor for cardiovascular disease? Nat Rev Rheumatol. 2012;8:587–98.PubMedCrossRef
25.
Innala L, Sjoberg C, Moller B, Ljung L, Smedby T, Sodergren A, et al. Co-morbidity in patients with early rheumatoid arthritis - inflammation matters. Arthritis Res Ther. 2016;18:33.PubMedPubMedCentralCrossRef
26.
Hoes JN, Bultink IE, Lems WF. Management of osteoporosis in rheumatoid arthritis patients. Expert Opin Pharmacother. 2015;16:559–71.PubMedCrossRef
27.
28.
Galliera E, Locati M, Mantovani A, Corsi MM. Chemokines and bone remodeling. Int J Immunopathol Pharmacol. 2008;21:485–91.PubMedCrossRef
29.
Ridker PM, Rifai N, Pfeffer M, Sacks F, Lepage S, Braunwald E. Elevation of tumor necrosis factor-alpha and increased risk of recurrent coronary events after myocardial infarction. Circulation. 2000;101:2149–53.CrossRefPubMed
30.
Barbour KE, Boudreau R, Danielson ME, Youk AO, Wactawski-Wende J, Greep NC, et al. Inflammatory markers and the risk of hip fracture: the Women’s Health Initiative. J Bone Miner Res. 2012;27:1167–76.PubMedCrossRef
31.
Gomez R, Conde J, Scotece M, Gomez-Reino JJ, Lago F, Gualillo O. What’s new in our understanding of the role of adipokines in rheumatic diseases? Nat Rev Rheumatol. 2011;7:528–36.PubMedCrossRef
32.
Kerekes G, Nurmohamed MT, Gonzalez-Gay MA, Seres I, Paragh G, Kardos Z, et al. Rheumatoid arthritis and metabolic syndrome. Nat Rev Rheumatol. 2014;10:691–6.PubMedCrossRef
33.
Neumann E, Junker S, Schett G, Frommer K, Muller-Ladner U. Adipokines in bone disease. Nat Rev Rheumatol. 2016;12:296–302.PubMedCrossRef
34.
Varri M, Niskanen L, Tuomainen T, Honkanen R, Kroger H, Tuppurainen MT. Association of adipokines and estradiol with bone and carotid calcifications in postmenopausal women. Climacteric. 2016;19:204–11.PubMedCrossRef
35.
Shimizu H, Nakagami H, Osako MK, Hanayama R, Kunugiza Y, Kizawa T, et al. Angiotensin II accelerates osteoporosis by activating osteoclasts. FASEB J. 2008;22:2465–75.PubMedCrossRef
36.
Kiechl S, Werner P, Knoflach M, Furtner M, Willeit J, Schett G. The osteoprotegerin/RANK/RANKL system: a bone key to vascular disease. Expert Rev Cardiovasc Ther. 2006;4:801–11.PubMedCrossRef
37.
38.
Venuraju SM, Yerramasu A, Corder R, Lahiri A. Osteoprotegerin as a predictor of coronary artery disease and cardiovascular mortality and morbidity. J Am Coll Cardiol. 2010;55:2049–61.PubMedCrossRef
39.
Wehmeyer C, Frank S, Beckmann D, Bottcher M, Cromme C, Konig U, et al. Sclerostin inhibition promotes TNF-dependent inflammatory joint destruction. Sci Transl Med. 2016;8:330ra335.CrossRef
40.
Gaudio A, Fiore V, Rapisarda R, Sidoti MH, Xourafa A, Catalano A, et al. Sclerostin is a possible candidate marker of arterial stiffness: Results from a cohort study in Catania. Mol Med Rep. 2017;15:3420–4.PubMedCrossRef
41.
Morrell NW, Bloch DB, ten Dijke P, Goumans MJ, Hata A, Smith J, et al. Targeting BMP signalling in cardiovascular disease and anaemia. Nat Rev Cardiol. 2016;13:106–20.PubMedCrossRef
42.
Holick MF. Sunlight and vitamin D for bone health and prevention of autoimmune diseases, cancers, and cardiovascular disease. Am J Clin Nutr. 2004;80(6 Suppl):1678S–88S.PubMedCrossRef
43.
Carvalho LS, Sposito AC. Vitamin D for the prevention of cardiovascular disease: Are we ready for that? Atherosclerosis. 2015;241:729–40.PubMedCrossRef
44.
Muscogiuri G, Annweiler C, Duval G, Karras S, Tirabassi G, Salvio G, et al. Vitamin D and cardiovascular disease: From atherosclerosis to myocardial infarction and stroke. Int J Cardiol. 2017;230:577–84.PubMedCrossRef
45.
46.
Brandenburg VM, Kleber ME, Vervloet MG, Tomaschitz A, Pilz S, Stojakovic T, et al. Fibroblast growth factor 23 (FGF23) and mortality: the Ludwigshafen Risk and Cardiovascular Health Study. Atherosclerosis. 2014;237:53–9.PubMedCrossRef
47.
Mirza MA, Karlsson MK, Mellstrom D, Orwoll E, Ohlsson C, Ljunggren O, et al. Serum fibroblast growth factor-23 (FGF-23) and fracture risk in elderly men. J Bone Miner Res. 2011;26:857–64.PubMedCrossRef
48.
Scatena M, Liaw L, Giachelli CM. Osteopontin: a multifunctional molecule regulating chronic inflammation and vascular disease. Arterioscler Thromb Vasc Biol. 2007;27:2302–9.PubMedCrossRef
49.
Lutgens E, Lutgens SP, Faber BC, Heeneman S, Gijbels MM, de Winther MP, et al. Disruption of the cathepsin K gene reduces atherosclerosis progression and induces plaque fibrosis but accelerates macrophage foam cell formation. Circulation. 2006;113:98–107.PubMedCrossRef
50.
51.
Byon CH, Chen Y. Molecular Mechanisms of Vascular Calcification in Chronic Kidney Disease: The Link between Bone and the Vasculature. Curr Osteoporos Rep. 2015;13:206–15.PubMedPubMedCentralCrossRef
52.
Zhang Y, Feng B. Systematic review and meta-analysis for the association of bone mineral density and osteoporosis/osteopenia with vascular calcification in women. Int J Rheum Dis. 2017;20:154–60.PubMedCrossRef
53.
Aleksova J, Kurniawan S, Vucak-Dzumhur M, Kerr P, Ebeling PR, Milat F, et al. Aortic vascular calcification is inversely associated with the trabecular bone score in patients receiving dialysis. Bone. 2018;113:118–23.PubMedCrossRef
54.
Barengolts EI, Berman M, Kukreja SC, Kouznetsova T, Lin C, Chomka EV. Osteoporosis and coronary atherosclerosis in asymptomatic postmenopausal women. Calcif Tissue Int. 1998;62:209–13.PubMedCrossRef
55.
Campos-Obando N, Kavousi M, Roeters van Lennep JE, Rivadeneira F, Hofman A, Uitterlinden AG, et al. Bone health and coronary artery calcification: The Rotterdam Study. Atherosclerosis. 2015;241:278–83.PubMedCrossRef
56.
Shaffer JR, Kammerer CM, Rainwater DL, O’Leary DH, Bruder JM, Bauer RL, et al. Decreased bone mineral density is correlated with increased subclinical atherosclerosis in older, but not younger, Mexican American women and men: the San Antonio Family Osteoporosis Study. Calcif Tissue Int. 2007;81:430–41.PubMedCrossRef
57.
Delgado-Frias E, Lopez-Mejias R, Genre F, Ubilla B, Gomez Rodriguez-Bethencourt MA, Gonzalez-Diaz A, et al. Relationship between endothelial dysfunction and osteoprotegerin, vitamin D, and bone mineral density in patients with rheumatoid arthritis. Clin Exp Rheumatol. 2015;33:241–9.PubMed
58.
Ye C, Xu M, Wang S, Jiang S, Chen X, Zhou X, et al. Decreased Bone Mineral Density Is an Independent Predictor for the Development of Atherosclerosis: A Systematic Review and Meta-Analysis. PLoS One. 2016;11:e0154740.PubMedPubMedCentralCrossRef
59.
Veronese N, Stubbs B, Crepaldi G, Solmi M, Cooper C, Harvey NC, et al. Relationship Between Low Bone Mineral Density and Fractures With Incident Cardiovascular Disease: A Systematic Review and Meta-Analysis. J Bone Miner Res. 2017;32:1126–35.PubMedCrossRef
60.
Jin ES, Jeong JH, Lee B, Im SB. Association factor analysis between osteoporosis with cerebral artery disease: The STROBE study. Medicine (Baltimore). 2017;96:e6164.CrossRef
61.
Varosy PD, Shlipak MG, Vittinghoff E, Black DM, Herrington D, Hulley SB, Heart, Estrogen/Progestin Replacement Study I, et al. Fracture and the risk of coronary events in women with heart disease. Am J Med. 2003;115:196–202.PubMedCrossRef
62.
Lems WF. Is Fragility Fracture a Strong Risk Factor for a Cardiovascular Event in Rheumatoid Arthritis? The Challenge of Dealing with Multiple Comorbidities. J Rheumatol. 2017;44:545–6.PubMedCrossRef
63.
Qu X, Huang X, Jin F, Wang H, Hao Y, Tang T, et al. Bone mineral density and all-cause, cardiovascular and stroke mortality: a meta-analysis of prospective cohort studies. Int J Cardiol. 2013;166:385–93.PubMedCrossRef
64.
Domiciano DS, Machado LG, Lopes JB, Figueiredo CP, Caparbo VF, Oliveira RM, et al. Bone Mineral Density and Parathyroid Hormone as Independent Risk Factors for Mortality in Community-Dwelling Older Adults: A Population-Based Prospective Cohort Study in Brazil. The Sao Paulo Ageing & Health (SPAH) Study. J Bone Miner Res. 2016;31:1146–57.PubMedCrossRef
65.
den Uyl D, Nurmohamed MT, van Tuyl LH, Raterman HG, Lems WF. (Sub)clinical cardiovascular disease is associated with increased bone loss and fracture risk; a systematic review of the association between cardiovascular disease and osteoporosis. Arthritis Res Ther. 2011;13:R5.CrossRef
66.
Sennerby U, Melhus H, Gedeborg R, Byberg L, Garmo H, Ahlbom A, et al. Cardiovascular diseases and risk of hip fracture. JAMA. 2009;302:1666–73.PubMedCrossRef
67.
Gerber Y, Melton LJ 3rd, Weston SA, Roger VL. Association between myocardial infarction and fractures: an emerging phenomenon. Circulation. 2011;124:297–303.PubMedPubMedCentralCrossRef
68.
Pouwels S, Lalmohamed A, Leufkens B, de Boer A, Cooper C, van Staa T, et al. Risk of hip/femur fracture after stroke: a population-based case-control study. Stroke 2009;40:3281–3285.PubMedCrossRef
69.
van Staa TP, Geusens P, Bijlsma JW, Leufkens HG, Cooper C. Clinical assessment of the long-term risk of fracture in patients with rheumatoid arthritis. Arthritis Rheum. 2006;54:3104–12.PubMedCrossRef
70.
Ni Mhuircheartaigh O, Crowson CS, Gabriel SE, Roger VL, Melton LJ 3rd, Amin S. Fragility Fractures Are Associated with an Increased Risk for Cardiovascular Events in Women and Men with Rheumatoid Arthritis: A Population-based Study. J Rheumatol. 2017;44:558–64.PubMedCrossRef
71.
72.
Provan SA, Olsen IC, Austad C, Haugeberg G, Kvien TK, Uhlig T. Calcium supplementation and inflammation increase mortality in rheumatoid arthritis: A 15-year cohort study in 609 patients from the Oslo Rheumatoid Arthritis Register. Semin Arthritis Rheum. 2017;46:411–7.PubMedCrossRef
73.
Cambridge G, Acharya J, Cooper JA, Edwards JC, Humphries SE. Antibodies to citrullinated peptides and risk of coronary heart disease. Atherosclerosis. 2013;228:243–6.PubMedCrossRef
74.
Hecht C, Englbrecht M, Rech J, Schmidt S, Araujo E, Engelke K, et al. Additive effect of anti-citrullinated protein antibodies and rheumatoid factor on bone erosions in patients with RA. Ann Rheum Dis. 2015;74:2151–6.PubMedCrossRef
75.
Rautiainen S, Wang L, Manson JE, Sesso HD. The role of calcium in the prevention of cardiovascular disease--a review of observational studies and randomized clinical trials. Curr Atheroscler Rep. 2013;15:362.PubMedCrossRef
76.
Lyles KW, Colon-Emeric CS, Magaziner JS, Adachi JD, Pieper CF, Mautalen C, et al. Zoledronic acid and clinical fractures and mortality after hip fracture. N Engl J Med. 2007;357:1799–809.PubMedCrossRef
77.
Samelson EJ, Miller PD, Christiansen C, Daizadeh NS, Grazette L, Anthony MS, et al. RANKL inhibition with denosumab does not influence 3-year progression of aortic calcification or incidence of adverse cardiovascular events in postmenopausal women with osteoporosis and high cardiovascular risk. J Bone Miner Res. 2014;29:450–7.PubMedCrossRef
78.
Walsh JS, Newman C, Eastell R. Heart drugs that affect bone. Trends Endocrinol Metab. 2012;23:163–8.PubMedCrossRef
79.
Nurmohamed MT, van Halm VP, Dijkmans BA. Cardiovascular risk profile of antirheumatic agents in patients with osteoarthritis and rheumatoid arthritis. Drugs. 2002;62:1599–609.PubMedCrossRef
80.
Buckley L, Guyatt G, Fink HA, Cannon M, Grossman J, Hansen KE, et al. 2017 American College of Rheumatology Guideline for the Prevention and Treatment of Glucocorticoid-Induced Osteoporosis. Arthritis Rheumatol. 2017;69:1521–37.PubMedCrossRef
81.
Cooper C, Bardin T, Brandi ML, Cacoub P, Caminis J, Civitelli R, et al. Balancing benefits and risks of glucocorticoids in rheumatic diseases and other inflammatory joint disorders: new insights from emerging data. An expert consensus paper from the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO). Aging Clin Exp Res. 2016;28:1–16.PubMedCrossRef
82.
Roubille C, Richer V, Starnino T, McCourt C, McFarlane A, Fleming P, et al. The effects of tumour necrosis factor inhibitors, methotrexate, non-steroidal anti-inflammatory drugs and corticosteroids on cardiovascular events in rheumatoid arthritis, psoriasis and psoriatic arthritis: a systematic review and meta-analysis. Ann Rheum Dis. 2015;74:480–9.PubMedCrossRef
83.
Torikai E, Kageyama Y, Takahashi M, Nagano A. The effect of methotrexate on bone metabolism markers in patients with rheumatoid arthritis. Mod Rheumatol. 2006;16:350–4.PubMedCrossRef
84.
Szekanecz Z, Szanto S, Szabo Z, Vancsa A, Szamosi S, Bodnar N, et al. Biologics - beyond the joints. Autoimmun Rev. 2010;9:820–4.PubMedCrossRef
85.
Greenberg JD, Furer V, Farkouh ME. Cardiovascular safety of biologic therapies for the treatment of RA. Nat Rev Rheumatol. 2011;8:13–21.PubMedCrossRef
86.
Low AS, Symmons DP, Lunt M, Mercer LK, Gale CP, Watson KD, British Society for Rheumatology Biologics Register for Rheumatoid A, the BCCC, et al. Relationship between exposure to tumour necrosis factor inhibitor therapy and incidence and severity of myocardial infarction in patients with rheumatoid arthritis. Ann Rheum Dis. 2016;76:654–60.CrossRef
87.
Vis M, Havaardsholm EA, Haugeberg G, Uhlig T, Voskuyl AE, van de Stadt RJ, et al. Evaluation of bone mineral density, bone metabolism, osteoprotegerin and receptor activator of the NFkappaB ligand serum levels during treatment with infliximab in patients with rheumatoid arthritis. Ann Rheum Dis. 2006;65:1495–9.PubMedPubMedCentralCrossRef
88.
Krieckaert CL, Nurmohamed MT, Wolbink G, Lems WF. Changes in bone mineral density during long-term treatment with adalimumab in patients with rheumatoid arthritis: a cohort study. Rheumatology (Oxford). 2013;52:547–53.CrossRef
89.
Baillet A, Gossec L, Carmona L, Wit M, van Eijk-Hustings Y, Bertheussen H, et al. Points to consider for reporting, screening for and preventing selected comorbidities in chronic inflammatory rheumatic diseases in daily practice: a EULAR initiative. Ann Rheum Dis. 2016;75:965–73.PubMedCrossRef
Metadata
Title
Common mechanisms and holistic care in atherosclerosis and osteoporosis
Authors
Zoltán Szekanecz
Hennie G. Raterman
Zsófia Pethő
Willem F. Lems
Publication date
01-12-2019
Publisher
BioMed Central
Published in
Arthritis Research & Therapy / Issue 1/2019
Electronic ISSN: 1478-6362
DOI
https://doi.org/10.1186/s13075-018-1805-7

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