Deminger A, Klingberg E, Lorentzon M, Hedberg M, Carlsten H, Jacobsson L T H, Forsblad-d'Elia H
Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Box 480, 405 30, Gothenburg, Sweden.
Department of Rheumatology, Region Västra Götaland, Sahlgrenska University Hospital, 413 45, Gothenburg, Sweden.
Osteoporos Int. 2022 Jan;33(1):205-216. doi: 10.1007/s00198-021-06049-4. Epub 2021 Jul 14.
Patients with ankylosing spondylitis (AS) have impaired volumetric bone mineral density (vBMD) assessed with high-resolution peripheral computed tomography (HRpQCT). This first longitudinal HRpQCT study in AS shows that cortical and trabecular vBMD decreased at tibia and that signs of inflammation were associated with cortical bone loss at tibia and radius.
Patients with ankylosing spondylitis (AS) have reduced volumetric bone mineral density (vBMD) in the peripheral skeleton assessed with high-resolution peripheral quantitative computed tomography (HRpQCT). The aims were to investigate longitudinal changes in vBMD, cortical area, and microarchitecture and to assess factors associated with changes in vBMD and cortical area in men with AS.
HRpQCT of radius and tibia was performed in 54 men with AS at baseline and after 5 years. Univariate and multivariable linear regression analyses were used.
At tibia, there were significant decreases exceeding least significant changes (LSC) in cortical and trabecular vBMD, mean (SD) percent change -1.0 (1.9) and -2.7 (5.0) respectively (p<0.001). In multivariable regression analyses, increase in disease activity measured by ASDAS_CRP from baseline to follow-up was associated with decreases in cortical vBMD (β -0.86, 95% CI -1.31 to -0.41) and cortical area (β -1.66, 95% CI -3.21 to -0.10) at tibia. At radius, no changes exceeded LSC. Nonetheless, increase in ASDAS_CRP was associated with decreases in cortical vBMD, and high time-averaged ESR was associated with decreases in cortical area. Treatment with TNF inhibitor ≥ 4 years during follow-up was associated with increases in cortical vBMD and cortical area at tibia, whereas exposure to bisphosphonates was associated with increases in cortical measurements at radius. No disease-related variables or treatments were associated with changes in trabecular vBMD.
The findings in this first longitudinal HRpQCT study in patients with AS strengthen the importance of controlling disease activity to maintain bone density in the peripheral skeleton.
强直性脊柱炎（AS）患者通过高分辨率外周计算机断层扫描（HRpQCT）评估的体积骨密度（vBMD）受损。这项针对AS患者的首次纵向HRpQCT研究表明，胫骨的皮质骨和小梁骨vBMD降低，并且炎症迹象与胫骨和桡骨的皮质骨丢失有关。
强直性脊柱炎（AS）患者通过高分辨率外周定量计算机断层扫描（HRpQCT）评估的外周骨骼体积骨密度（vBMD）降低。目的是研究vBMD、皮质面积和微观结构的纵向变化，并评估与AS男性患者vBMD和皮质面积变化相关的因素。
对54名AS男性患者在基线和5年后进行桡骨和胫骨的HRpQCT检查。采用单变量和多变量线性回归分析。
在胫骨，皮质骨和小梁骨vBMD有显著下降，超过最小显著变化（LSC），平均（标准差）百分比变化分别为-1.0（1.9）和-2.7（5.0）（p<0.001）。在多变量回归分析中，从基线到随访期间用ASDAS_CRP测量的疾病活动增加与胫骨皮质骨vBMD（β -0.86，95%CI -1.31至-0.41）和皮质面积（β -1.66，95%CI -3.21至-0.10）的降低有关。在桡骨，没有变化超过LSC。尽管如此，ASDAS_CRP增加与皮质骨vBMD降低有关，高时间平均ESR与皮质面积降低有关。随访期间使用TNF抑制剂≥4年与胫骨皮质骨vBMD和皮质面积增加有关，而暴露于双膦酸盐与桡骨皮质测量增加有关。没有疾病相关变量或治疗与小梁骨vBMD变化有关。
这项针对AS患者的首次纵向HRpQCT研究结果强化了控制疾病活动以维持外周骨骼骨密度的重要性。
