Speden Deborah J, Calin Andre I, Ring Francis J, Bhalla Ashok K
Royal National Hospital for Rheumatic Diseases, Bath, UK.
J Rheumatol. 2002 Mar;29(3):516-21.
To assess bone mineral density (BMD) by dual energy x-ray absorptiometry (DEXA) and calcaneal quantitative ultrasound (QUS) in a cohort of pre- and postmenopausal women with ankylosing spondylitis (AS), and to determine any relationships with markers of bone turnover and disease activity or severity.
Fifty premenopausal and 16 postmenopausal women with AS were studied. Clinical and radiological status was assessed by the Bath AS Disease Activity Index (BASDAI), Bath AS Functional Index (BASFI), Bath AS Metrology Index (BASMI), and Bath AS Radiology Index (BASRI). BMD of the hip and spine was measured by DEXA, and QUS measured at the heel. Serum osteocalcin (OC), bone-specific alkaline phosphatase (BALP), urinary D-pyridinoline crosslinks (D-PYR), and C-reactive protein (CRP) were assayed.
Women with AS (n = 66) had reduced BMD at the hip compared to age and sex matched controls (n = 132). The mean t scores were -1.1 and -2.0, and z scores -0.4 and -0.37, for pre- and postmenopausal women, respectively. Four (6%) had osteoporosis and 34 (52%) had osteopenia according to the WHO definitions. Using a multiple regression model, femoral neck BMD was found to be significantly affected by age, body mass index, and the sacroiliac radiographic score. There were no significant correlations of BMD with disease duration or disease activity. QUS measures did not correlate with DEXA measures of BMD. Women with AS had significantly lower markers of bone formation, OC and BALP, and a trend to higher D-PYR than controls. Serum OC levels correlated negatively with femoral neck BMD, whereas D-PYR correlated with CRP levels.
Women with AS have reduced hip BMD, 0.39 SD below age and sex matched controls. Bone turnover in women with AS is characterized by low OC and BALP.
采用双能X线吸收法（DEXA）和跟骨定量超声（QUS）评估一组绝经前和绝经后强直性脊柱炎（AS）女性的骨密度（BMD），并确定其与骨转换标志物以及疾病活动度或严重程度之间的关系。
对50名绝经前和16名绝经后AS女性进行研究。通过巴斯强直性脊柱炎疾病活动指数（BASDAI）、巴斯强直性脊柱炎功能指数（BASFI）、巴斯强直性脊柱炎计量指数（BASMI）和巴斯强直性脊柱炎放射学指数（BASRI）评估临床和放射学状态。采用DEXA测量髋部和脊柱的骨密度，用QUS测量足跟骨密度。检测血清骨钙素（OC）、骨特异性碱性磷酸酶（BALP）、尿D-吡啶啉交联物（D-PYR）和C反应蛋白（CRP）。
与年龄和性别匹配的对照组（n = 132）相比，AS女性（n = 66）的髋部骨密度降低。绝经前和绝经后女性的平均t值分别为-1.1和-2.0，z值分别为-0.4和-0.37。根据世界卫生组织的定义，4名（6%）患有骨质疏松症，34名（52%）患有骨质减少症。使用多元回归模型发现，股骨颈骨密度受年龄、体重指数和骶髂关节放射学评分的显著影响。骨密度与疾病持续时间或疾病活动度无显著相关性。QUS测量值与DEXA测量的骨密度不相关。AS女性的骨形成标志物OC和BALP显著低于对照组，D-PYR有高于对照组的趋势。血清OC水平与股骨颈骨密度呈负相关，而D-PYR与CRP水平相关。
AS女性的髋部骨密度降低，比年龄和性别匹配的对照组低0.39个标准差。AS女性的骨转换特点是OC和BALP水平低。
