scholarly journals DISORDERS OF STRUCTURAL AND FUNCTIONAL STATE OF BONE TISSUE IN MEN WITH ANKYLOSING SPONDYLITIS, THEIR RELATION TO DISEASE COURSE

2021 ◽  
Vol 74 (8) ◽  
pp. 1856-1862
Author(s):  
Sergii Shevchuk ◽  
Oksanа Pavliuk

The aim: To study the structural and functional state of bone tissue in men with ankylosing spondylitis and to asses its relationship with the course of the disease. Materials and methods: the study was conducted involving 105 men, aged 40.74 ± 0.87 years and 25 generally healthy individuals of the certain age and sex, who formed the control group. The functional ability was assessed by the BASFI index and the disease activity was calculated by ASDAS-CRP and BASDAI. Laboratory criteria for the activity of the inflammatory process were considered erythrocyte sedimentation rate and C-reactive protein. Bone mineral density of the lumbar spine and femoral neck was determined by dual energy X-ray absorptiometry. Results: osteoporosis and osteopenic syndrome were identified in men with ankylosing spondylitis in 27,7% and 29,5% consequently. Disorder of the structural and functional state of bone tissue was closely related to the total indicators of inflammatory activity in ASDAS-CRP (r = –0,36), BASDAI (r = –0,51), the functional index BASFI (r = –0,30), C-reactive protein (r = –0,30) and the cumulative dose of glucocorticoids (r = –0.32). The comparative analysis of densitometric parameters in groups of patients depending on the form of the disease has not shown statistically significant differences. Conclusions: The decrease in bone mineral density in patients with ankylosing spondylitis does not depend on age and duration of the disease, but is associated with the cumulative dose of glucocorticoids and high activity of the inflammatory process.

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 674.2-675
Author(s):  
A. Efremova ◽  
N. Toroptsova ◽  
N. Demin ◽  
O. Dobrovolskaya ◽  
O. Nikitinskaya

Background:Chronic inflammatory rheumatic diseases are risk factors of bone loss and fractures. Systemic sclerosis (SSc) has been recognized to be another potential inflammatory joint disease that may affect bone tissue.Objectives:to evaluate bone mineral density (BMD) and risk factors of low BMD in women with SSc.Methods:173 women, among them 110 postmenopausal (median age 60[55,63] years) and 63 premenopausal (median age 35[31,44] years). BMD was measured at lumbar spine (LS), femoral neck (FN) and total hip (TH) by dual energy X-ray absorptiometry (DXA, Hologic 4500A). Low BMD was diagnosed if the T-score was < -1.0 standard deviation (SD) in postmenopausal women and if the Z-score was < -2.0 SD in premenopausal women. The relationship between BMD and SSc patients’ characteristics was evaluated using univariate linear regression analysis.Results:Low BMD was found in 66% patients: 79% - in postmenopausal and 18% - in premenopausal women. Among postmenopausal persons osteoporosis was discovered in 47% and osteopenia – in 32% cases. In postmenopausal woman BMD of LS, FN and TH were associated with body mass index (BMI) (β=0.27, p=0.010; β=0.47, p<0,001 and β=0.45, p<0,001, respectively), duration of glucocorticoids (GCs) using (β=-0.31, p=0.008; β=-0.34, p=0.003 and β=-0.27, p=0.022, respectively); BMD of FN and TH with C-reactive protein (β= -0.32, p=0.016 and β= -0.29, p=0.029, respectively) and LS BMD with current and cumulative GCs dose (β= -0.24, p=0.039 and β= -0.29, p=0.014, respectively). In premenopausal women BMD of LS, FN and TH were associated with BMI (β=0.51, p<0,001; β=0.45, p=0.003 and β=0.47, p=0.002, respectively), duration of GCs using (β= -0.45, p=0.004; β= -0.47, p=0.003 and β= -0.48, p=0.002, respectively) and GCs cumulative dose (β= -0.48, p=0.002; β= -0.51, p=0.001 and β= -0.46, p=0.004, respectively); BMD of FN and TH with 25(ОН)D level (β=0.52, p=0.008 and β=0.54, p=0.005, respectively), and LS BMD with SSc duration (β= -0.44, p=0.004).Conclusion:Low BMD was diagnosed in 66% of women with SSc. Low BMI, GCs cumulative dose and duration of GCs using were independent risk factors for low BMD in both premenopausal and postmenopausal persons. Additional factors as SSc duration and low vitamin D level were found out for premenopausal and current GCs dose and C-reactive protein level for postmenopausal women.Disclosure of Interests:None declared


Metabolites ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 526
Author(s):  
Silke Zimmermann ◽  
Maria Beatriz Walter Costa ◽  
Akash Mathew ◽  
Shruthi Krishnan ◽  
Jochen G. Schneider ◽  
...  

Bone-derived osteocalcin has been suggested to be a metabolic regulator. To scrutinize the relation between osteocalcin and peripheral insulin sensitivity, we analyzed changes in serum osteocalcin relative to changes in insulin sensitivity, low-grade inflammation, and bone mineral density following lifestyle-induced weight loss in individuals with metabolic syndrome (MetS). Participants with MetS were randomized to a weight loss program or to a control group. Before and after the 6-month intervention period, clinical and laboratory parameters and serum osteocalcin levels were determined. Changes in body composition were analyzed by dual-energy X-ray absorptiometry (DXA). In participants of the intervention group, weight loss resulted in improved insulin sensitivity and amelioration of inflammation. Increased serum levels of osteocalcin correlated inversely with BMI (r = −0.63; p< 0.001), total fat mass (r = −0.58, p < 0.001), total lean mass (r = −0.45, p < 0.001), C-reactive protein (CRP) (r = −0.37; p < 0.01), insulin (r = −0.4; p < 0.001), leptin (r = −0.53; p < 0.001), triglycerides (r = −0.42; p < 0.001), and alanine aminotransferase (ALAT) (r = −0.52; p < 0.001). Regression analysis revealed that osteocalcin was independently associated with changes in CRP but not with changes in insulin concentration, fat mass, or bone mineral density, suggesting that weight loss-induced higher serum osteocalcin is primarily associated with reduced inflammation.


2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1759.2-1759
Author(s):  
N. Toroptsova ◽  
O. Dobrovolskaya ◽  
O. Nikitinskaya ◽  
N. Demin ◽  
A. Smirnov ◽  
...  

Background:The onset of the disease in young and middle age is typical for rheumatic diseases (RDS), but most studies on osteoporosis were conducted in patients (pts) older than 50 years, which included postmenopausal women.Objectives:To assess bone mineral density (BMD), fracture frequency and the factors associated with low BMD in premenopausal women with RDs.Methods:160 women (median age, 36 [29; 43] years): 120 pts with RDs (43 rheumatoid arthritis (RA), 53 systemic sclerosis (SSc) and 24 psoriatic arthritis (PsA)) and 40 age-matched healthy controls were enrolled in the study. We performed a dual-energy X-ray absorptiometry (DXA, Hologic Discovery A, USA) to measure BMD in lumbar spine, femoral neck and total hip. BMD decreasing grade was evaluated by the Z-score <-2SD. All pts were interviewed using a unified questionnaire including assessment of daily dietary calcium intake. Serum vitamin D, C-reactive protein and erythrocyte sedimentation rate (ESR) measurements were done.Results:25% pts with RDs and only 8% healthy controls have low BMD (p=0.02). RA, SSc and PsA pts had low BMD in 37%, 21% and 13%, respectively, that was more often than in healthy women (p=0.004, p=0.046 and p= 0.081, respectively). 9,3% RA pts and 7,5% SSc pts had low energy fractures. BMD of RDs pts in all areas of measurement demonstrated a direct correlation with height, weight, body mass index, and serum vitamin D concentration and an inverse correlation with the cumulative dose of glucocorticoids. Also, proximal femur BMD inversely correlated with RDs duration. BMD of femoral neck and total hip inversely correlated with C-reactive protein level in SSc pts. In RA women we found a direct correlation between lumbar spine and femur neck BMD and ESR.Conclusion:25% of premenopausal women with RDs had reduced BMD and needed monitoring and osteoporosis prevention, while 9.3% pts with RA and 7.5% women with SSc needed anti-osteoporotic treatment.Disclosure of Interests:None declared


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