Department of Rheumatology, VU University Medical Center, Room 3A-64, PO Box 7057, 1007 MB, Amsterdam, The Netherlands.
Clin Rheumatol. 2011 Apr;30(4):497-503. doi: 10.1007/s10067-010-1538-8. Epub 2010 Aug 10.
The objective of this study was to determine the prevalence and risk factors of low bone mineral density (BMD) in patients with spondylarthropathies (SpA) at an early stage of disease. In this cross-sectional study, the BMD of lumbar spine and hips was measured in 130 consecutive early SpA patients. The outcome measure BMD was defined as (1) osteoporosis, (2) osteopenia, and (3) normal bone density. Logistic regression analyses were used to investigate relations between the following variables: age, gender, disease duration, diagnosis, HLA-B27, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Metrology Index (BASMI), extra-spinal manifestations and medication, with outcome measure low BMD (osteopenia and/or osteoporosis). The SpA population had a median time since diagnosis of 6.6 months and a disease duration of 6.3 years. In total, 9% of the early SpA patients had osteoporosis, 38% osteopenia, and 53% normal BMD. On univariate analyses, male gender, diagnosis of ankylosing spondylitis, increased CRP, high BASFI, and high BASMI were significantly associated with low BMD. Factors showing a relation with low BMD in the multivariate model were male gender (OR 4.18, 95% confidence interval (CI) 1.73-10.09), high BASMI (OR 1.54, 95% CI 1.14-2.07), and high BASFI (OR 1.18, 95% CI 1.00-1.39). In early SpA patients, a high frequency (47%) of low BMD in femur as well as in lumbar spine was found. Low BMD was associated with male gender and decreased functional capacity. These findings emphasize the need for more alertness for osteoporosis and osteopenia in spondylarthropathy patients at an early stage of the disease.
本研究旨在确定早期脊柱关节病(SpA)患者低骨密度(BMD)的患病率和危险因素。在这项横断面研究中,对 130 例连续早期 SpA 患者的腰椎和髋关节 BMD 进行了测量。结果测量 BMD 定义为(1)骨质疏松症,(2)骨量减少和(3)正常骨密度。使用逻辑回归分析调查了以下变量之间的关系:年龄、性别、疾病持续时间、诊断、HLA-B27、红细胞沉降率(ESR)、C 反应蛋白(CRP)、Bath 强直性脊柱炎疾病活动指数(BASDAI)、Bath 强直性脊柱炎功能指数(BASFI)、Bath 强直性脊柱炎计量指数(BASMI)、脊柱外表现和药物与结果测量低 BMD(骨质疏松症和/或骨量减少)之间的关系。SpA 人群的诊断后中位时间为 6.6 个月,疾病持续时间为 6.3 年。共有 9%的早期 SpA 患者患有骨质疏松症,38%的患者患有骨量减少症,53%的患者的 BMD 正常。单变量分析显示,男性、强直性脊柱炎的诊断、CRP 升高、BASFI 高和 BASMI 高与低 BMD 显著相关。多变量模型中与低 BMD 相关的因素是男性(OR 4.18,95%置信区间(CI)1.73-10.09)、高 BASMI(OR 1.54,95% CI 1.14-2.07)和高 BASFI(OR 1.18,95% CI 1.00-1.39)。在早期 SpA 患者中,发现股骨和腰椎的低 BMD 发生率很高(47%)。低 BMD 与男性和功能能力下降有关。这些发现强调了在疾病早期对脊柱关节病患者的骨质疏松症和骨量减少症保持更高警惕的必要性。