RefereraExporteraLink to record
Permanent link

Direct link
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Annet format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annet språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf
Which measuring site in ankylosing spondylitis is best to detect bone loss and what predicts the decline: results from a 5-year prospective study
Vise andre og tillknytning
2017 (engelsk)Inngår i: Arthritis Research & Therapy, ISSN 1478-6354, E-ISSN 1478-6362, Vol. 19, artikkel-id 273Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Background: Studies have shown increased prevalence of osteoporosis and increased risk for vertebral fractures in patients with ankylosing spondylitis (AS). Measurements of bone mineral density (BMD) in the lumbar spine anterior-posterior (AP) projection may be difficult to interpret due to the ligamentous calcifications, and the lateral projection might be a better measuring site. Our objectives were to investigate BMD changes after 5 years at different measuring sites in patients with AS and to evaluate disease-related variables and medications as predictors for BMD changes.

Methods: In a longitudinal study, BMD in Swedish AS patients, 50 +/- 13 years old, was measured with dual-energy x-ray absorptiometry (DXA) at the hip, the lumbar spine AP and lateral projections, and the total radius at baseline and after 5 years. Patients were assessed with questionnaires, blood samples, and spinal radiographs for grading of AS-related alterations in the spine with the modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS) and assessment of vertebral fractures by the Genant score. Multiple linear regression analyses were used to investigate predictors for BMD changes.

Results: Of 204 patients included at baseline, 168 (82%) were re-examined after 5 years (92 men and 76 women). BMD decreased significantly at the femoral neck and radius and increased significantly at the lumbar spine, both for AP and lateral projections. Mean C-reactive protein during follow-up predicted a decrease in the femoral neck BMD (change in %, beta = -0.15, p = 0.046). Use of bisphosphonates predicted an increase in BMD at all measuring sites (p < 0.001 to 0.013), except for the total radius. Use of tumor necrosis factor inhibitors (TNFi) predicted an increase in AP spinal BMD (beta = 3.15, p = 0.012).

Conclusion: The current study (which has a long follow-up, many measuring sites, and is the first to longitudinally assess the lateral projection of the spine in AS patients) surprisingly showed that lateral projection spinal BMD increased. This study suggests that the best site to assess bone loss in AS patients is the femoral neck and that inflammation has an adverse effect, and the use of bisphosphonates and TNFi has a positive effect, on BMD in AS patients.

sted, utgiver, år, opplag, sider
BIOMED CENTRAL LTD , 2017. Vol. 19, artikkel-id 273
Emneord [en]
Ankylosing spondylitis, Osteoporosis, Bone mineral density, Inflammation, Longitudinal study
HSV kategori
Identifikatorer
URN: urn:nbn:se:umu:diva-143522DOI: 10.1186/s13075-017-1480-0ISI: 000417527100004PubMedID: 29216909OAI: oai:DiVA.org:umu-143522DiVA, id: diva2:1170455
Tilgjengelig fra: 2018-01-03 Laget: 2018-01-03 Sist oppdatert: 2018-01-13bibliografisk kontrollert

Open Access i DiVA

fulltext(1760 kB)7 nedlastinger
Filinformasjon
Fil FULLTEXT01.pdfFilstørrelse 1760 kBChecksum SHA-512
fec0339cefb1d4240f42357b6c51bc109813574735051e998dd2f92a5323e8a65bc0caa7066e2011d9d0ce5cbf4fcac767ad3d89990b8e45964741581e3a475b
Type fulltextMimetype application/pdf

Andre lenker

Forlagets fulltekstPubMed

Søk i DiVA

Av forfatter/redaktør
Forsblad-d'Elia, Helena
Av organisasjonen
I samme tidsskrift
Arthritis Research & Therapy

Søk utenfor DiVA

GoogleGoogle Scholar
Totalt: 7 nedlastinger
Antall nedlastinger er summen av alle nedlastinger av alle fulltekster. Det kan for eksempel være tidligere versjoner som er ikke lenger tilgjengelige

doi
pubmed
urn-nbn

Altmetric

doi
pubmed
urn-nbn
Totalt: 9 treff
RefereraExporteraLink to record
Permanent link

Direct link
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Annet format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annet språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf