Vertebral Fractures in Ankylosing Spondylitis Are Associated with Lower Bone Mineral Density in Both Central and Peripheral Skeleton

2012 ◽  
Vol 39 (10) ◽  
pp. 1987-1995 ◽  
Author(s):  
EVA KLINGBERG ◽  
MATS GEIJER ◽  
JAN GÖTHLIN ◽  
DAN MELLSTRÖM ◽  
MATTIAS LORENTZON ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
New York ◽  
Ankylosing Spondylitis ◽  
Femoral Neck ◽  
Bone Mineral ◽  
Vertebral Fractures ◽  
Disease Duration ◽  
Mineral Density ◽  
Lateral Spine ◽  
Peripheral Skeleton

Objective.To study the prevalence and risk factors for vertebral fractures (VF) in ankylosing spondylitis (AS) and the relation between VF, measures of disease activity, and bone mineral density (BMD) in different measurement sites.Methods.Patients with AS (modified New York criteria) underwent examination, answered questionnaires, and gave blood samples. Lateral spine radiographs were scored for VF (Genant score) and syndesmophyte formation through modified Stoke Ankylosing Spondylitis Spine Score (mSASSS). BMD was measured with dual-energy x-ray absorptiometry in the hip, radius, and lumbar spine in anteroposterior and lateral projections with estimation of volumetric BMD (vBMD).Results.Two hundred four patients (57% men) with a mean age of 50 ± 13 years and disease duration 15 ± 11 years were included. VF were diagnosed in 24 patients (12%), but were previously noted clinically in only 3 of the 24. Patients with VF were significantly older (p = 0.004), had longer disease duration (p = 0.011), higher Bath Ankylosing Spondylitis Metrology Index (p = 0.011), mSASSS (p = 0.035), and Bath Ankylosing Spondylitis patient global score-2 (BASG-2) (p = 0.032) and were more often smokers (p = 0.032). All women with a VF were postmenopausal. BMD was significantly lower at all measuring sites in the patients with VF. In logistic regression, high BASG-2, low BMD in femoral neck, and low lumbar vBMD were independently associated with presence of VF.Conclusion.VF in AS are common but are often not diagnosed. VF are associated with advanced age, longstanding disease, impaired back mobility, syndesmophyte formation, and lower BMD in both the central and peripheral skeleton. BMD in the femoral neck, total hip, and estimated vBMD showed the strongest association with VF.

Anti-tumor Necrosis Factor Therapy Increased Spine and Femoral Neck Bone Mineral Density of Patients with Active Ankylosing Spondylitis with Low Bone Mineral Density

2015 ◽  
Vol 42 (8) ◽  
pp. 1413-1417 ◽  
Author(s):  
Haibo Li ◽  
Qiuxia Li ◽  
Xi Chen ◽  
Chen Ji ◽  
Jieruo Gu
Keyword(s):  
Bone Mineral Density ◽  
Ankylosing Spondylitis ◽  
Femoral Neck ◽  
Bone Mineral ◽  
Tumor Necrosis ◽  
Control Group ◽  
Study Group ◽  
Type I ◽  
Mineral Density ◽  
Necrosis Factor

Objective.To evaluate the effect of anti-tumor necrosis factor (TNF) therapy on bone mineral density (BMD) in patients with active ankylosing spondylitis (AS) with low BMD.Methods.Eighty-nine patients with active AS with low BMD were randomly divided into either a study group or a control group. The study group received etanercept (50 mg/week) or adalimumab (40 mg/2 week) subcutaneously for 1 year. BMD of lumbar spine and femoral neck was measured by dual energy X-ray absorptiometry, and bone turnover markers serum C telopeptide of type-I collagen (sCTX) and serum procollagen type-I N propeptide (PINP) were detected by ELISA at baseline and at end of study.Results.After 1 year, compared with baseline, there was a significant increase in spine and femoral neck BMD by a mean ± SD of 14.9% ± 15.6% (p < 0.0001) and 4.7% ± 7.9% (p < 0.0001) in the study group. In the control group, there was a significant decrease in spine and femoral neck BMD by a mean ± SD of −8.6% ± 9.7% (p < 0.0001) and −9.8% ± 11.5% (p < 0.0001). Compared with baseline, sCTX was significantly decreased in the study group (−40% at 1 yr, p < 0.0001), but bone-specific alkaline phosphatase and PINP increased (45.6%, p < 0.0001 and 30.8%, p < 0.0001, respectively).Conclusion.In patients with active AS with low BMD, the spine and femoral neck BMD increased after anti-TNF therapy for 1 year, and it was accompanied by a significant decrease in bone resorption markers and an increase in bone formation markers.

scholarly journals Preoperative and Postoperative Bone Mineral Density Change and Risk Factor Analysis in Patients with a GH-Secreting Pituitary Adenoma

2019 ◽  
Vol 2019 ◽  
pp. 1-8
Author(s):  
Li’nan Qin ◽  
Xiaopeng Guo ◽  
Lu Gao ◽  
Zihao Wang ◽  
Chenzhe Feng ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Risk Factor ◽  
Lumbar Spine ◽  
Femoral Neck ◽  
Bone Mineral ◽  
Pituitary Adenomas ◽  
Disease Duration ◽  
Femoral Shaft ◽  
Mineral Density ◽  
Total Hip

Purpose. This study analysed changes in bone mineral density (BMD) at different sites in patients with acromegaly and postoperative BMD changes and explored risk factors associated with BMD. Methods. Clinical data of 39 patients with growth hormone- (GH-) secreting pituitary adenomas and 29 patients with nonfunctioning pituitary adenomas who were newly diagnosed in neurosurgery from January 2016 to December 2018 were retrospectively analysed, including measurements of preoperative and postoperative BMD, serum GH glucose inhibition, random GH and IGF-1, and other anterior pituitary hormones. Results. The average patient age and disease duration were 43.74 (33.41–54.07) years and 72.15 (22.82–121.48) months, respectively. Compared with patients with nonfunctioning adenomas, patients with GH-secreting pituitary adenomas had significantly higher BMDs at L1, L2, femoral neck, Ward triangle, trochanter, femoral shaft, and total hip sites (p<0.05). The BMD Z score at L1 and femoral neck sites significantly increased (p<0.05). Thirteen patients underwent re-examination of BMD 1 year postsurgery, and the BMD Z score was reduced to normal levels at L1, L2, L3, L4, L1-L4, and L2-L4 compared with preoperative levels (p<0.05). Postoperative BMD Z scores in the femoral neck and total hip were significantly increased (p<0.05). Disease duration was negatively correlated with the lumbar-spine BMD Z score. IGF-1 burden was negatively correlated with the BMD Z score at L1 and L1–L4. Multiple regression analysis showed that IGF-1 burden was a risk factor for a BMD Z score decrease at L1 and L1–L4. Conclusion. BMD in patients with GH-secreting pituitary adenomas (compared with nonfunctional adenomas) increased at L1, L2, femoral neck, Ward triangle, trochanter, femoral shaft, and total hip sites. Lumbar-spine BMD Z score recovered to normal levels postsurgically when GH and IGF-1 levels were controlled. BMD Z score was negatively correlated with disease duration and IGF-1 burden in patients with GH-secreting pituitary adenomas, and IGF-1 burden was an independent risk factor for reduced lumbar-spine BMD Z score.

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