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Bone microarchitecture in ankylosing spondylitis and the association with bone mineral density, fractures, and syndesmophytes.
Arthritis Res Ther. 2013; 15(6):R179.AR

Abstract

INTRODUCTION

Osteoporosis of the axial skeleton is a known complication of ankylosing spondylitis (AS), but bone loss affecting the peripheral skeleton is less studied. This study on volumetric bone mineral density (vBMD) and bone microarchitecture in AS was conducted to compare peripheral vBMD in AS patients with that in healthy controls, to study vBMD in axial compared with peripheral bone, and to explore the relation between vertebral fractures, spinal osteoproliferation, and peripheral bone microarchitecture and density.

METHODS

High-resolution peripheral quantitative computed tomography (HRpQCT) of ultradistal radius and tibia and QCT and dual-energy x-ray absorptiometry (DXA) of lumbar spine were performed in 69 male AS patients (NY criteria). Spinal radiographs were assessed for vertebral fractures and syndesmophyte formation (mSASSS). The HRpQCT measurements were compared with the measurements of healthy controls.

RESULTS

The AS patients had lower cortical vBMD in radius (P = 0.004) and lower trabecular vBMD in tibia (P = 0.033), than did the controls. Strong correlations were found between trabecular vBMD in lumbar spine, radius (rS = 0.762; P < 0.001), and tibia (rS = 0.712; P < 0.001). When compared with age-matched AS controls, patients with vertebral fractures had lower lumbar cortical vBMD (-22%; P = 0.019), lower cortical cross-sectional area in radius (-28.3%; P = 0.001) and tibia (-24.0%; P = 0.013), and thinner cortical bone in radius (-28.3%; P = 0.001) and tibia (-26.9%; P = 0.016). mSASSS correlated negatively with trabecular vBMD in lumbar spine (rS = -0.620; P < 0.001), radius (rS = -0.400; p = 0.001) and tibia (rS = -0.475; p < 0.001) and also with trabecular thickness in radius (rS = -0.528; P < 0.001) and tibia (rS = -0.488; P < 0.001). Adjusted for age, syndesmophytes were significantly associated with decreasing trabecular vBMD, but increasing cortical vBMD in lumbar spine, but not with increasing cortical thickness or density in peripheral bone. Estimated lumbar vBMD by DXA correlated with trabecular vBMD measured by QCT (rS = 0.636; P < 0.001).

CONCLUSIONS

Lumbar osteoporosis, syndesmophytes, and vertebral fractures were associated with both lower vBMD and deteriorated microarchitecture in peripheral bone. The results indicate that trabecular bone loss is general, whereas osteoproliferation is local in AS.

Authors

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Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24517240

Citation

Klingberg, Eva, et al. "Bone Microarchitecture in Ankylosing Spondylitis and the Association With Bone Mineral Density, Fractures, and Syndesmophytes." Arthritis Research & Therapy, vol. 15, no. 6, 2013, pp. R179.
Klingberg E, Lorentzon M, Göthlin J, et al. Bone microarchitecture in ankylosing spondylitis and the association with bone mineral density, fractures, and syndesmophytes. Arthritis Res Ther. 2013;15(6):R179.
Klingberg, E., Lorentzon, M., Göthlin, J., Mellström, D., Geijer, M., Ohlsson, C., Atkinson, E. J., Khosla, S., Carlsten, H., & Forsblad-d'Elia, H. (2013). Bone microarchitecture in ankylosing spondylitis and the association with bone mineral density, fractures, and syndesmophytes. Arthritis Research & Therapy, 15(6), R179.
Klingberg E, et al. Bone Microarchitecture in Ankylosing Spondylitis and the Association With Bone Mineral Density, Fractures, and Syndesmophytes. Arthritis Res Ther. 2013;15(6):R179. PubMed PMID: 24517240.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Bone microarchitecture in ankylosing spondylitis and the association with bone mineral density, fractures, and syndesmophytes. AU - Klingberg,Eva, AU - Lorentzon,Mattias, AU - Göthlin,Jan, AU - Mellström,Dan, AU - Geijer,Mats, AU - Ohlsson,Claes, AU - Atkinson,Elizabeth J, AU - Khosla,Sundeep, AU - Carlsten,Hans, AU - Forsblad-d'Elia,Helena, PY - 2013/07/03/received PY - 2013/10/15/accepted PY - 2014/2/13/entrez PY - 2014/2/13/pubmed PY - 2014/11/5/medline SP - R179 EP - R179 JF - Arthritis research & therapy JO - Arthritis Res Ther VL - 15 IS - 6 N2 - INTRODUCTION: Osteoporosis of the axial skeleton is a known complication of ankylosing spondylitis (AS), but bone loss affecting the peripheral skeleton is less studied. This study on volumetric bone mineral density (vBMD) and bone microarchitecture in AS was conducted to compare peripheral vBMD in AS patients with that in healthy controls, to study vBMD in axial compared with peripheral bone, and to explore the relation between vertebral fractures, spinal osteoproliferation, and peripheral bone microarchitecture and density. METHODS: High-resolution peripheral quantitative computed tomography (HRpQCT) of ultradistal radius and tibia and QCT and dual-energy x-ray absorptiometry (DXA) of lumbar spine were performed in 69 male AS patients (NY criteria). Spinal radiographs were assessed for vertebral fractures and syndesmophyte formation (mSASSS). The HRpQCT measurements were compared with the measurements of healthy controls. RESULTS: The AS patients had lower cortical vBMD in radius (P = 0.004) and lower trabecular vBMD in tibia (P = 0.033), than did the controls. Strong correlations were found between trabecular vBMD in lumbar spine, radius (rS = 0.762; P < 0.001), and tibia (rS = 0.712; P < 0.001). When compared with age-matched AS controls, patients with vertebral fractures had lower lumbar cortical vBMD (-22%; P = 0.019), lower cortical cross-sectional area in radius (-28.3%; P = 0.001) and tibia (-24.0%; P = 0.013), and thinner cortical bone in radius (-28.3%; P = 0.001) and tibia (-26.9%; P = 0.016). mSASSS correlated negatively with trabecular vBMD in lumbar spine (rS = -0.620; P < 0.001), radius (rS = -0.400; p = 0.001) and tibia (rS = -0.475; p < 0.001) and also with trabecular thickness in radius (rS = -0.528; P < 0.001) and tibia (rS = -0.488; P < 0.001). Adjusted for age, syndesmophytes were significantly associated with decreasing trabecular vBMD, but increasing cortical vBMD in lumbar spine, but not with increasing cortical thickness or density in peripheral bone. Estimated lumbar vBMD by DXA correlated with trabecular vBMD measured by QCT (rS = 0.636; P < 0.001). CONCLUSIONS: Lumbar osteoporosis, syndesmophytes, and vertebral fractures were associated with both lower vBMD and deteriorated microarchitecture in peripheral bone. The results indicate that trabecular bone loss is general, whereas osteoproliferation is local in AS. SN - 1478-6362 UR - https://www.unboundmedicine.com/medline/citation/24517240/Bone_microarchitecture_in_ankylosing_spondylitis_and_the_association_with_bone_mineral_density_fractures_and_syndesmophytes_ L2 - https://arthritis-research.biomedcentral.com/articles/10.1186/ar4368 DB - PRIME DP - Unbound Medicine ER -