Cai Peng Li, Yan Yun Yu, Wei Wei, Chen Xiao Shuai, Zhao Jian, Zhang Ze Kun, Zhang Ping
Department of Radiology, The third Hospital of Hebei Medical University, Hebei Province Biomechanical Key Laborary of Orthopedics.
Department of Radiology, Chinese medicine hospital of Hebei Provience, Shijiazhuang, Hebei, China.
Medicine (Baltimore). 2020 Feb;99(8):e19132. doi: 10.1097/MD.0000000000019132.
The osteoporosis was common complication of ankylosing spondylitis (AS), but it was frequently unrecognized in the initial stage of the disease. This study was to compare areal bone mineral density (BMD) of hip joints in early AS patients with that in healthy controls, to explore the progress of bone loss in cortex and spongiosa in early AS.Quantitative computed tomography (QCT) of hip was performed in 60 AS patients (modified New York criteria for AS, with grade 2 sacroiliitis in computed tomography) and 57 healthy controls. The QCT measurements of AS patients were compared with the measurements of healthy controls.The AS patients had lower areal BMD in cortical bone and total bone of proximal femur in early AS patients (P < .01), than the controls. But there were not significant different of areal BMD in spongiosa of proximal femur between the early AS patients and healthy controls. Strong correlations were found between body mass index BMI, areal BMD in cortical bone (rs = 0.410, P < .001; rs = 0.422, P < .001) and total bone (rs = 0.368, P < .001; rs = 0.266, P = .003) both in AS patients and healthy controls.The results indicate that osteopenia/osteoporosis is general in early stage of AS. What is more, the osteopenia/osteoporosis in cortex is earlier than in spongiosa of proximal femur in early AS.
骨质疏松症是强直性脊柱炎(AS)的常见并发症,但在疾病初期常常未被识别。本研究旨在比较早期AS患者与健康对照者髋关节的面积骨密度(BMD),以探讨早期AS患者皮质骨和松质骨骨量丢失的进展情况。
对60例AS患者(采用改良纽约AS标准,CT显示骶髂关节炎2级)和57例健康对照者进行了髋关节定量计算机断层扫描(QCT)。将AS患者的QCT测量结果与健康对照者的测量结果进行比较。
早期AS患者的皮质骨和股骨近端全骨的面积BMD低于对照组(P<0.01)。但早期AS患者与健康对照者股骨近端松质骨的面积BMD无显著差异。在AS患者和健康对照者中,体重指数BMI与皮质骨面积BMD(rs=0.410,P<0.001;rs=0.422,P<0.001)以及全骨面积BMD(rs=0.368,P<0.001;rs=0.266,P=0.003)之间均存在强相关性。
结果表明,AS早期普遍存在骨质减少/骨质疏松。此外,AS早期皮质骨的骨质减少/骨质疏松比股骨近端松质骨更早出现。