Department of Rheumatology and Immunology, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China.
Graduate School, Second Military Medical University, Shanghai 200433, China.
Chin Med J (Engl). 2021 Oct 13;134(21):2556-2563. doi: 10.1097/CM9.0000000000001787.
Ankylosing spondylitis (AS) is a common chronic progressive rheumatic disease. The aim of this study was to explore factors influencing abnormal bone mineral density (BMD) in young and middle-aged patients with AS.
From July 2014 to August 2018, hospitalized patients with AS and health examinees in the health examination center of our clinics, ranging in age from 20 to 50 years, were monitored. The BMD of the lumbar spine and femoral neck of AS patients and those of a healthy control group were measured using dual-energy X-ray absorption. The BMDs of AS patients were compared with respect to age, course of disease, iritis, smoking habits, sex, height, weight, body mass index (BMI), medication use, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), platelet volume, platelet count, uric acid (UA), alkaline phosphatase (AKP), and calcium ion levels. Single-nucleotide polymorphisms (SNPs) related to BMD were screened using genome-wide association analysis.
There was no statistical difference in the proportion of abnormal bone masses between the different body parts. The BMD of all bones in AS patients was lower than that in healthy controls (P < 0.05). Additionally, BMD was correlated with serum calcium and CRP in AS patients (P < 0.05), but not with age, platelet volume, platelet count, ESR, UA, AKP, height, weight, and BMI. The incidence of abnormal bone mass in AS patients was correlated with sex (P < 0.05), but not with medication use, iritis, or smoking. BMD of the lumbar spine in AS patients did not correlate linearly with the course of the disease, but BMD of the femoral neck correlated linearly with the course of the disease (P < 0.05). BMD was correlated with multiple SNPs in patients with AS. Lumbar BMD was correlated with rs7025373 and rs7848078. Femoral head BMD was correlated with 3:102157365, 3:102157417, rs1252202, rs1681355, rs3891857, rs7842614, and rs9870734, suggesting that genetic factors play a role in BMD in patients with AS.
The proportion of abnormal bone mass in AS patients was higher than that in healthy individuals of the same age. The factors related to BMD in patients with AS are gender, CRP, and blood calcium. The BMD of the femoral neck of AS patients decreases with the course of the disease, but BMD of the lumbar spine is not related to the course of the disease. BMD in AS patients is associated with multiple SNPs.
强直性脊柱炎（AS）是一种常见的慢性进行性风湿性疾病。本研究旨在探讨影响中青年 AS 患者骨密度（BMD）异常的因素。
2014 年 7 月至 2018 年 8 月，监测我院门诊收治的年龄 20-50 岁的 AS 患者和体检中心健康体检者的 BMD。采用双能 X 线吸收法测量 AS 患者的腰椎和股骨颈 BMD。比较 AS 患者的 BMD 与年龄、病程、虹膜炎、吸烟习惯、性别、身高、体重、体重指数（BMI）、用药、红细胞沉降率（ESR）、C 反应蛋白（CRP）、血小板体积、血小板计数、尿酸（UA）、碱性磷酸酶（AKP）、钙离子水平。采用全基因组关联分析筛选与 BMD 相关的单核苷酸多态性（SNP）。
不同部位的骨量异常比例无统计学差异。AS 患者全身各部位 BMD 均低于健康对照组（P＜0.05）。此外，AS 患者的 BMD 与血清钙和 CRP 相关（P＜0.05），但与年龄、血小板体积、血小板计数、ESR、UA、AKP、身高、体重和 BMI 无关。AS 患者骨量异常的发生率与性别有关（P＜0.05），但与用药、虹膜炎或吸烟无关。AS 患者腰椎 BMD 与病程无线性相关，而股骨颈 BMD 与病程呈线性相关（P＜0.05）。AS 患者的 BMD 与多个 SNP 相关。腰椎 BMD 与 rs7025373 和 rs7848078 相关。股骨头 BMD 与 3:102157365、3:102157417、rs1252202、rs1681355、rs3891857、rs7842614 和 rs9870734 相关，提示遗传因素在 AS 患者的 BMD 中起作用。
AS 患者的骨量异常比例高于同年龄健康人群。与 AS 患者 BMD 相关的因素是性别、CRP 和血钙。AS 患者的股骨颈 BMD 随病程而降低，但腰椎 BMD 与病程无关。AS 患者的 BMD 与多个 SNP 相关。
