PT  - JOURNAL ARTICLE
AU  - Ashika Chhana
AU  - Opetaia Aati
AU  - Gregory D.  Gamble
AU  - Karen E.  Callon
AU  - Anthony J.  Doyle
AU  - Mark Roger
AU  - Fiona M.  McQueen
AU  - Anne Horne
AU  - Ian R.  Reid
AU  - Jillian Cornish
AU  - Nicola Dalbeth
TI  - Path Analysis Identifies Receptor Activator of Nuclear Factor-κB Ligand, Osteoprotegerin, and Sclerostin as Potential Mediators of the Tophus-bone Erosion Relationship in Gout
AID  - 10.3899/jrheum.150738
DP  - 2016 Jan 15
TA  - The Journal of Rheumatology
PG  - jrheum.150738
4099  - http://www.jrheum.org/content/early/2016/01/02/jrheum.150738.short
4100  - http://www.jrheum.org/content/early/2016/01/02/jrheum.150738.full
AB  - Objective To determine the relationship between tophus, erosion and bone remodeling factors in gout. Methods Computed tomography bone erosion and circulating bone factors were measured in adults with tophaceous gout. Multiple regression modeling and path analysis were used to determine predictors of erosion. Results Tophus number, Māori or Pacific ethnicity, creatinine, receptor activator of nuclear factor-κB ligand (RANKL), osteoprotegerin (OPG), and sclerostin were independently associated with erosion. Path analysis showed a direct effect of tophus number on erosion, partially mediated through OPG, RANKL, and sclerostin. Conclusion Tophus number is strongly associated with bone erosion in gout. Circulating RANKL, OPG, and sclerostin are potential mediators of tophus-related erosion.