Talotta Rossella, Rucci Francesco, Scaglione Francesco
Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Messina, Azienda Ospedaliera Gaetano Martino, Messina, Italy.
Medical Affairs Department, Pulmonary Hypertension, Janssen-Cilag SpA, Cologno Monzese, Milan, Italy.
Reumatologia. 2020;58(5):297-311. doi: 10.5114/reum.2020.100112. Epub 2020 Oct 20.
The aim of this review is to describe the metabolism of calcium in ankylosing spondylitis compared to physiologic conditions, and to present the current evidence on the benefits and disadvantages of calcium supplementation in these patients. A narrative review of the literature was conducted using the PubMed database and a total of 65 articles were selected. Calcium is involved in many physiopathological processes, including inflammation, bone loss and bone formation, all of which occur in ankylosing spondylitis. Many ankylosing spondylitis patients suffer from concomitant osteopenia or osteoporosis, which represent indications for calcium supplementation. Conversely, there are still concerns about the use of calcium salts for the prevention of bone fragility in non-osteoporotic or non-osteopenic patients. In these cases, biologic agents may indirectly normalize calcium dysmetabolism by rebalancing the cytokine milieu, in turn associated with bone remodeling. Calcium supplements may be disadvantageous for entheseal calcifications, but so far there are no clear data confirming that such an association exists.
本综述的目的是描述与生理状况相比，强直性脊柱炎患者钙的代谢情况，并阐述目前关于这些患者补充钙的利弊的证据。使用PubMed数据库对文献进行了叙述性综述，共筛选出65篇文章。钙参与许多生理病理过程，包括炎症、骨质流失和骨形成，所有这些过程都发生在强直性脊柱炎患者身上。许多强直性脊柱炎患者伴有骨质减少或骨质疏松，这表明需要补充钙。相反，对于非骨质疏松或非骨质减少患者使用钙盐预防骨脆性仍存在担忧。在这些情况下，生物制剂可能通过重新平衡细胞因子环境间接使钙代谢紊乱正常化，而细胞因子环境又与骨重塑相关。补钙可能对附着点钙化不利，但目前尚无明确数据证实存在这种关联。
