Bone tissue metabolism in men with ankylosing spondylitis
Section snippets
INTRODUCTION
Osteoporosis is now known to occur in association will all patterns of chronic inflammatory joint disease. Osteoporosis associated with ankylosing spondylitis (AS) seems to be of the secondary nature. Even slight injury can cause fracture within vertebral column and make patients seriously physically handicapped in consequence. Comprehensive studies of mechanisms responsible for osteoporosis associated with AS are essential to develop effective prophylactic antiresorptive treatment for AS
MATERIALS AND METHODS
The diagnosis of AS was established on the basis of modified New York Criteria [2]. The Bath ankylosing spondylitis disease activity index (BASDAI) score were used to measure disease activity (on a scale of 0–10) [3]. The mean BASDAI was 3.71 ± 1.6 (median 3.82). Each patient had diagnosis confirmed by radiological examination of the sacroiliac joints, which revealed bilateral lesions in stage 2 to 4. Protocol of the study was approved by the Bioethical Comity of the University of Medical
An assessment of BMD in distal part of forearm
BMD values for AS patients varied from case to case but were generally rated between 0.304 g/cm2 and 0.632 g/cm2; an average value was 0.522 g/cm2 ± 0.067; median 0.531 g/cm2. BMD values in the group of AS patients with normal T score oscillated between 0.556 g/cm2 and 0.632 g/cm2, an average value 0.588 g/cm2 ± 0.025, median 0.582 g/cm2, whereas in the group of AS patients with osteopenia or osteoporosis the BMD values oscillated between 0.304 g/cm2 to 0.555 g/cm2, an average value 0.492 g/cm2
DISCUSSION
Abnormal bone structure, impaired elasticity and accompanying bone mass loss are characteristic features of AS [4]. The main factor responsible for the development of osteoporosis in AS patient is an active local and general inflammation process. In male other factors such us: long – term corticoid therapy (16.4%), alcoholism (16%), tobacco smoking (14.6%), hypogonadism (10.1%), hypercalciuria, chronic liver illnesses, Crohn's disease, low calcium diet, hyperthyroidism and immobilization can
CONCLUSIONS
Based on the obtained data our results suggest that there was an accelerated loss of bone tissue observed in patients with AS compared to the healthy population. The presence of osteopenia/osteoporosis was associated with longer duration of the disease and with higher age. In the overall group of AS patients bone degradation marker, Dpd, correlated with serum concentration of IL-6, TNF-alpha and CRP, and inversely with BMD measured in the forearm. However, no direct association could be
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