The relation between osteoporosis and vitamin D levels and disease activity in ankylosing spondylitis
The relation between osteoporosis and vitamin D levels and disease activity in ankylosing spondylitis
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DOI：
10.1007/s00296-009-0975-7
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发表时间：
2010-01-01
影响因子：
4
通讯作者：
Oezoran, Kuersat
中科院分区：
文献类型：
--
作者：
Baskan, Bedriye Mermerci;Dogan, Yasemin Pekin;Oezoran, Kuersat
本研究旨在探讨强直性脊柱炎（AS）患者骨质疏松与维生素D及疾病活动性的关系。100例AS患者和58例健康人被纳入研究。除了常规的血液和尿液检查，血清25-（OH）D3，甲状旁腺激素（PTH），C-反应蛋白（CRP），红细胞沉降率（ESR），总钙，离子钙，磷水平的所有参与者也进行了测量。在前后和侧腰椎和股骨区域进行骨矿物质密度（BMD）测量。对所有参与者进行前后位和侧位胸部和腰骶部X线摄影。用Bath强直性脊柱炎疾病活动指数（BASDAI）评价疾病活动度，用Bath强直性脊柱炎功能指数（BASFI）评价功能状态，用Bath强直性脊柱炎计量指数（BASMI）评价活动度。在患者组中，从侧腰椎和股骨区域获得的BMD值和血清维生素D水平低于对照组。AS患者侧位腰椎BMD值与ESR、CRP和BASDAI评分呈负相关。与无骨质疏松症的患者相比，AS合并骨质疏松症患者的ESR、CRP水平和BASMI评分显著升高。AS患者血清25-（OH）D3水平与ESR、CRP水平的负相关性未达到统计学显著水平; PTH水平与ESR的正相关性、CRP与BASDAI的负相关性也未达到统计学显著水平。AS中维生素D缺乏可能通过引起炎症活动增加而间接导致骨质疏松症。本文作者认为，监测维生素D水平与骨密度测量一起，以确定骨质疏松症风险的患者是有益的。
In this study, the relation between osteoporosis and vitamin D and the disease activity in patients with ankylosing spondylitis (AS) was investigated. A hundred patients with AS and 58 healthy individuals were included in the study. In addition to the routine blood and urine tests, serum 25-(OH)D3, parathormone (PTH), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), total calcium, ionized calcium, and phosphorous levels of all participants were also measured. Bone mineral density (BMD) measurements were performed at the anterior-posterior and lateral lumbar and femur regions. Anterior-posterior and lateral thoracic and lumbosacral radiography was performed on all participants. The disease activity was evaluated by Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), functional status by Bath Ankylosing Spondylitis Functional Index (BASFI), and mobility by Bath Ankylosing Spondylitis Metrology Index (BASMI). In the patient group, BMD values obtained from the lateral lumbar and femur regions and serum vitamin D levels were lower than the control group. A negative relation was determined between the lateral lumbar BMD values and ESR, CRP, and BASDAI scores of patients with AS. The ESR, CRP levels, and BASMI scores of the AS patients with osteoporosis were significantly higher, when compared to patients without osteoporosis. The negative correlation between serum 25-(OH)D3 level and ESR, CRP levels did not reach a statistically significant level in patients with AS; the positive correlation between PTH levels and ESR, and the negative correlation between CRP and BASDAI also did not reach a statistically significant level. Vitamin D deficiency in AS may indirectly lead to osteoporosis by causing an increase in the inflammatory activity. The present authors believe that it would be beneficial to monitorize vitamin D levels together with BMD measurements in order to determine the patients under osteoporosis risk.