osteoporosis in ankylosing spondylitis - prevalence, risk factors and methods of assessment骨质疏松症在强直性脊柱炎-患病率,危险因素和评估的方法.pdfVIP

Klingberg et al. Arthritis Research Therapy 2012, 14:R108 /content/14/3/R108 RESEARCH ARTICLE Open Access Osteoporosis in ankylosing spondylitis - prevalence, risk factors and methods of assessment 1,2* 2 2 3 4 5 6 Eva Klingberg , Mattias Lorentzon , Dan Mellström , Mats Geijer , Jan Göthlin , Elisabet Hilme , Martin Hedberg , Hans Carlsten1,2 and Helena Forsblad-d’Elia1,2 Abstract Introduction: 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: 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). Results: 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