Would 14-3-3η enable an approach to personalized medicine for secondary osteoporosis in rheumatoid arthritis?

Abstract Background: Early identification and disease monitoring of secondary osteoporosis(OP) in rheumatoid arthritis (RA) are challenges for rheumatologists, identification of biomarkers predictive to bone mineral density (BMD) change is crucial in management. Serum 14-3-3η protein is validated as a diagnostic and prognostic biomarker in RA. Meanwhile the exact mechanism by which 14-3-3η intervenes osteoporosis is still unclear and few studies have been focused on it. Our aim was to evaluate the association among 14-3-3η protein, inflammation, bone remodeling, osteoporosis risk and disease activity in RA patients. Methods: Bone mineral density was measured using dual energy X-ray absorptiometry, serum samples were collected for all participants. Quantitative enzyme-linked immunosorbent assay (ELISA) was used to determine 14-3-3η, TNF-α and IL-6 levels. Meanwhile, B-CTX and PINP were measured using electrochemical luminescence immune-analyzer. The diagnostic value of each marker was determined via receiver operating characteristic (ROC) curve, and the association between 14-3-3η and osteoporosis was assessed using multiple logistic regression which identified 14-3-3η as an independent risk factor for RA-related osteoporosis. Results: Seventy-two RA patients and twenty five controls. Patients were divided into three subgroups, normal BMD, osteopenia, and osteoporotic. Serum 14-3-3 η, TNF-α, B-CTX and IL-6 level were the highest and PINP is the lowest in osteoporosis group, There were significant differences among the subgroups (p<0.05). Also, there were significant positive correlation between 14-3-3 η and TNF-α,B-CTX ,IL-6 (p<0.05) while it had significant negative correlation with both BMD, PINP (p<0.05). Conclusion Serum 14-3-3η is independent risk factor for RA-related osteoporosis. Serum 14-3-3η detection by itself or combined with other indices was helpful in predicting osteoporosis. Its effect on osteoporosis may be due to its role in adjusting inflammation and bone remodeling.