Osteoporosis in ankylosing spondylitis - prevalence, risk factors and methods of assessment.
Osteoporosis in ankylosing spondylitis - prevalence, risk factors and methods of assessment.
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DOI：
10.1186/ar3833
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发表时间：
2012-05-08
影响因子：
4.9
通讯作者：
Forsblad-d'Elia H
中科院分区：
文献类型：
--
作者：
Klingberg E;Lorentzon M;Mellström D;Geijer M;Göthlin J;Hilme E;Hedberg M;Carlsten H;Forsblad-d'Elia H
骨质疏松症可能是强直性脊柱炎（AS）的并发症，但诊断脊柱骨质疏松症可能很困难，因为病理性新骨形成会干扰骨矿物质密度（BMD）的评估。当前研究的目的是调查瑞典AS患者中骨密度降低的患病率和危险因素，并利用腰椎双能x线骨密度仪（DXA）检查进行性强直如何影响骨密度。评估方法包括问卷调查、背部活动能力测试、血液样本、脊柱侧位x线片（mSASSS）、髋关节、桡骨和腰椎正位（AP）的DXA和侧位投影（体积骨密度（vBMD））。纳入AS患者（修正纽约标准），女性87例，男性117例，平均年龄50±13岁，病程15±11年。根据世界卫生组织（WHO）的标准，bb0 = 50岁的患者中有21%的骨质疏松症和44%的骨质减少。在50岁以下，5%的人骨密度低于预期的年龄范围。有趣的是，与AP DXA相比，侧位腰椎DXA显示出明显较低的骨密度，并显示出明显更多的骨质疏松病例。腰椎vBMD在性别之间没有差异，但AP DXA测量的女性腰椎骨质疏松症明显更多（P < 0.001）。男性的mSASSS显著高于男性（P < 0.001）。低骨密度与高年龄、病程、mSASSS、巴斯强直性脊柱炎计量指数（BASMI）、炎症参数和低体重指数（BMI）相关。增加的mSASSS与侧位和容积腰椎骨密度降低显著相关，而AP腰椎骨密度有增加的趋势。骨质疏松和骨质减少在AS中很常见，并与高疾病负担相关。侧位和容量腰椎DXA在检测骨质疏松症方面比AP DXA更敏感，受联合苔藓形成的影响较小。
Osteoporosis can be a complication of ankylosing spondylitis (AS), but diagnosing spinal osteoporosis can be difficult since pathologic new bone formation interferes with the assessment of the bone mineral density (BMD). The aims of the current study were to investigate prevalence and risk factors for reduced BMD in a Swedish cohort of AS patients, and to examine how progressive ankylosis influences BMD with the use of dual-energy x-ray absorptiometry (DXA) of the lumbar spine in different projections. Methods of assessment were questionnaires, back mobility tests, blood samples, lateral spine radiographs for syndesmophyte grading (mSASSS), DXA of the hip, radius and lumbar spine in anteroposterior (AP) and lateral projections with estimation of volumetric BMD (vBMD). AS patients (modified New York criteria), 87 women and 117 men, mean age 50 ± 13 years and disease duration 15 ± 11 years were included. According to World Health Organization (WHO) criteria 21% osteoporosis and 44% osteopenia was diagnosed in patients > = 50 years. Under age 50 BMD below expected range for age was found in 5%. Interestingly lateral lumbar DXA showed significantly lower BMD and revealed significantly more cases with osteoporosis as compared with AP DXA. Lumbar vBMD was not different between sexes, but women had significantly more lumbar osteoporosis measured with AP DXA (P < 0.001). Men had significantly higher mSASSS (P < 0.001). Low BMD was associated with high age, disease duration, mSASSS, Bath Ankylosing Spondylitis Metrology Index (BASMI), inflammatory parameters and low body mass index (BMI). Increasing mSASSS correlated significantly with decreasing lateral and volumetric lumbar BMD, while AP lumbar BMD showed tendency to increase. Osteoporosis and osteopenia is common in AS and associated with high disease burden. Lateral and volumetric lumbar DXA are more sensitive than AP DXA in detecting osteoporosis and are less affected by syndesmophyte formation.
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影响因子：
4
作者：
Lange, U;Kluge, A;Bachmann, G
通讯作者：
Bachmann, G
影响因子：
4
作者：
Baskan, Bedriye Mermerci;Dogan, Yasemin Pekin;Oezoran, Kuersat
通讯作者：
Oezoran, Kuersat
影响因子：
2.6
作者：
BLAKE, GM;JAGATHESAN, T;FOGELMAN, I
通讯作者：
FOGELMAN, I
影响因子：
27.4
作者：
DONNELLY, S;DOYLE, DV;SPECTOR, TD
通讯作者：
SPECTOR, TD
影响因子：
2.2
作者：
Mannerkorpi, K;Hernelid, C
通讯作者：
Hernelid, C