{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T14:10:48Z","timestamp":1781791848959,"version":"3.54.5"},"reference-count":45,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,6,9]],"date-time":"2022-06-09T00:00:00Z","timestamp":1654732800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100012553","name":"Chang Gung Memorial Hospital","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100012553","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To explore the impact of seropositivity on systemic bone loss in rheumatoid arthritis (RA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted an interim analysis of the RA registry. Patients were examined with dual-energy X-ray absorptiometry at baseline and again 3 years later. Participants were grouped into seropositive (SPRA) and seronegative (SNRA) based on the presence or absence of rheumatoid factor (RF) and\/or anti-cyclic citrullinated peptide antibodies (ACPA). After matching (1:2) for age and sex, SNRA and SPRA patients were divided into groups A and B. Each matched group (A or B) was further subdivided according to the number of antibodies present (0, group I; 1, group II; 2, group III). Multiple ordinary least squares regression was used with the dependent variables to develop a model to predict bone mineral density (BMD) change.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 477 participants who completed a 3-year observation period were included. After matching, 312 participants were enrolled (group A, 104; group B, 208). Three years later, group B had significant BMD reduction in the femoral neck (FN) (<jats:italic>p<\/jats:italic> &amp;lt; 0.001), total hip (TH) (<jats:italic>p<\/jats:italic> = 0.001), and first through fourth lumbar vertebrae (L1\u20134) (<jats:italic>p<\/jats:italic> = 0.006), while group A had bone loss only at FN (<jats:italic>p<\/jats:italic> = 0.002). Groups I, II, and III included 104, 52, and 156 participants, respectively. Compared to baseline, BMD decreased significantly at FN (<jats:italic>p<\/jats:italic> = 0.002) in group I, FN (<jats:italic>p<\/jats:italic> &amp;lt; 0.001) in group II, and FN (<jats:italic>p<\/jats:italic> &amp;lt; 0.001), TH (<jats:italic>p<\/jats:italic> = 0.002), and L1\u20134 (<jats:italic>p<\/jats:italic> = 0.016) in group III. In terms of regression-adjusted percent change in BMD, more significantly negative changes were found at all measured sites in group B (<jats:italic>p<\/jats:italic> &amp;lt; 0.001, all) and at TH and L1\u20134 within groups I-III (<jats:italic>p<\/jats:italic> for trend &amp;lt; 0.001 and &amp;lt; 0.001, respectively). Regardless of antibodies, anti-osteoporotic therapy can preserve bone density in RA patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>After 3 years, SPRA patients lost more bone density than SNRA patients. More attention should be paid to SPRA patients, especially those with double-positive antibodies, including a vigorous evaluation of BMD and fracture risk. Anti-osteoporotic therapy can prevent BMD loss irrespective of autoantibodies.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2022.885801","type":"journal-article","created":{"date-parts":[[2022,6,9]],"date-time":"2022-06-09T05:16:16Z","timestamp":1654751776000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["The Impact of Seropositivity on Systemic Bone Loss in Rheumatoid Arthritis\u2014A 3-Year Interim Analysis of a Longitudinal Observational Cohort 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