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Research ArticleArticle

Path Analysis Identifies Receptor Activator of Nuclear Factor-κB Ligand, Osteoprotegerin, and Sclerostin as Potential Mediators of the Tophus-bone Erosion Relationship in Gout

Ashika Chhana, Opetaia Aati, Gregory D. Gamble, Karen E. Callon, Anthony J. Doyle, Mark Roger, Fiona M. McQueen, Anne Horne, Ian R. Reid, Jillian Cornish and Nicola Dalbeth
The Journal of Rheumatology February 2016, 43 (2) 445-449; DOI: https://doi.org/10.3899/jrheum.150738
Ashika Chhana
From the Bone and Joint Research Group, the Department of Medicine, the Department of Anatomy with Radiology, and the Department of Molecular Medicine and Pathology, University of Auckland; and the Department of Radiology, Auckland District Health Board, Auckland, New Zealand.
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Opetaia Aati
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Gregory D. Gamble
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Karen E. Callon
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Anthony J. Doyle
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Mark Roger
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Fiona M. McQueen
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Anne Horne
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Ian R. Reid
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Jillian Cornish
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Nicola Dalbeth
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  • For correspondence: n.dalbeth@auckland.ac.nz
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    Figure 1.

    Standardized path coefficients (controlling for serum creatinine and ethnicity) from the path analysis investigating putative causal pathways of bone erosion in gout. Total R2 = 0.58, p < 0.0001. RANKL: receptor activator of nuclear factor-κB ligand; OPG: osteoprotegerin; CT: computed tomography.

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    Table 1.

    Clinical characteristics and their correlations with CT erosion score. Data are mean (SD) unless indicated otherwise.

    Clinical FeaturesPearson rP
    Age, yrs56 (12)−0.050.66
    Male sex, n (%)94 (94)—0.24†
    Ethnicity, n (%)—0.03†
      Pacific42 (42)
      Māori18 (18)
      Non-Māori, non-Pacific40 (40)
    Gout disease duration, yrs22 (11)0.200.051
    No. subcutaneous tophi7.3 (7.1)0.62< 0.001
    Serum urate, mmol/l0.38 (0.12)0.220.29
    Serum creatinine, μmol/l97 (23)0.340.001
    RANKL concentration, pmol/l0.28 (0.65)0.440.001
    OPG concentration, pg/ml2214 (1272)0.270.006
    Sclerostin concentration, pg/ml696 (338)−0.290.003
    DKK-1 concentration, pg/ml3412 (1992)−0.080.46
    FGF-23 concentration, pg/ml7.1 (11.8)0.180.08
    P1NP concentration, μg/l56.9 (33.3)0.160.12
    β-CTX concentration, ng/ml0.29 (0.16)0.070.46
    • Pearson r and p refer to correlation with CT erosion score.

    • ↵† P value shown for comparison of erosion scores between groups. CT: computed tomography; RANKL: receptor activator of nuclear factor-κB ligand; OPG: osteoprotegerin; DKK: Dickkopf 1; FGF-23: fibroblast growth factor 23; P1NP: procollagen type-1 N-terminal propeptide; CTX: collagen cross-linked C-telopeptide, type I.

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    Table 2.

    Multiple linear regression analysis. Standardized β coefficient, partial R2 and regression p are shown for those variables that met an inclusion criterion of p < 0.15 from a fully saturated model of variables selected from external clinical judgment, for an association with erosion score.

    Clinical FeaturesModel Constructed from External Clinical JudgmentReduced Model (F = 17.8, R2 = 0.58, p < 0.0001)
    Standardized β CoefficientpStandardized β CoefficientpPartial R2
    Age−0.0450.635
    Sex0.0230.769
    Māori or Pacific ethnicity0.1690.0480.1710.0165%
    Gout disease duration0.0880.259
    Total no. tophi0.459< 0.00010.460< 0.000139%
    Serum urate0.0570.469
    Serum creatinine0.1820.0380.2220.0045%
    RANKL concentration0.1840.0410.2090.0093%
    OPG concentration0.1420.1190.1580.0362%
    Sclerostin concentration−0.1680.028−0.1720.0193%
    DKK-1 concentration−0.0600.480
    FGF-23 concentration0.0120.892
    P1NP concentration0.1220.197
    β-CTX concentration−0.2220.033−0.125880.103
    • RANKL: receptor activator of nuclear factor-κB ligand; OPG: osteoprotegerin; DKK: Dickkopf 1; FGF-23: fibroblast growth factor 23; P1NP: procollagen type-1 N-terminal propeptide; CTX: collagen cross-linked C-telopeptide, type I.

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Path Analysis Identifies Receptor Activator of Nuclear Factor-κB Ligand, Osteoprotegerin, and Sclerostin as Potential Mediators of the Tophus-bone Erosion Relationship in Gout
Ashika Chhana, Opetaia Aati, Gregory D. Gamble, Karen E. Callon, Anthony J. Doyle, Mark Roger, Fiona M. McQueen, Anne Horne, Ian R. Reid, Jillian Cornish, Nicola Dalbeth
The Journal of Rheumatology Feb 2016, 43 (2) 445-449; DOI: 10.3899/jrheum.150738

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Path Analysis Identifies Receptor Activator of Nuclear Factor-κB Ligand, Osteoprotegerin, and Sclerostin as Potential Mediators of the Tophus-bone Erosion Relationship in Gout
Ashika Chhana, Opetaia Aati, Gregory D. Gamble, Karen E. Callon, Anthony J. Doyle, Mark Roger, Fiona M. McQueen, Anne Horne, Ian R. Reid, Jillian Cornish, Nicola Dalbeth
The Journal of Rheumatology Feb 2016, 43 (2) 445-449; DOI: 10.3899/jrheum.150738
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Keywords

GOUT
BONE
EROSION
RANKL
OPG
SCLEROSTIN

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Keywords

  • gout
  • BONE
  • EROSION
  • RANKL
  • OPG
  • SCLEROSTIN

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