Is Osteoporosis Generalized or Localized to Central Skeleton in Ankylosing Spondylitis?

Sarıkaya, Selda; Başaran, Aynur; Tekin, Yasin; Özdolap, Şenay; Ortancil, Özgür

doi:10.1097/01.rhu.0000255688.83037.42

Cited by 28 publications

(18 citation statements)

References 22 publications

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“…Apart from a cross-sectional design the limitation of this study is the lack of data for bone turnover markers, parathyroide hormone or vitamin D3, which could have revealed a better insight of association between activity parameters of both osteoporosis and AS [37,38].…”

Section: Discussionmentioning

confidence: 99%

Relationship of bone mineral density with disease activity and functional ability in patients with ankylosing spondylitis: a cross-sectional study

et al. 2011

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SummaryAim. In ankylosing spondylitis (AS) inflammatory activity probably plays a key role in the pathophysiology of bone loss. The aim of the study was to investigate the relationship of bone mineral density (BMD) at the lumbar spine and hip region with some measures of disease activity and functional ability in patients with ankylosing spondylitis.Methods: In 80 patients with established ankylosing spondylitis disease activity and functional ability were determined by C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and Bath Ankylosing Spondylitis Functional Index (BASFI). Spinal pain and patient global health were assessed using horizontal visual analogue scale (VAS). BMD was measured by dual-energy x-ray absorptiometry (DXA).Results. There was a significant negative correlation of bone density T scores with acute phase reactants (i.e. patients with lower T scores had higher level of CRP and ESR). That relationship was reflected more reliably at proximal femur sites than at the lumbar spine.There were also significant differences in ESR, BASDAI, BASFI, spinal pain and global health between three groups of patients according to WHO classification of osteoporosis (normal, osteopenic and osteoporotic). Significantly more patients with osteopenia at the lumbar spine had lower BASDAI index than those with normal BMD (p=0.030). Conclusion:Our results indicate an association of low BMD with high disease activity in patients with AS. Femoral BMD seems to be more associated with disease activity and functional ability than lumbar spine BMD.

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Section: Discussionmentioning

confidence: 99%

Relationship of bone mineral density with disease activity and functional ability in patients with ankylosing spondylitis: a cross-sectional study

et al. 2011

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“…Although it could appear paradoxical, excessive bony proliferation and osteoporosis occur simultaneously in patients with AS, suggesting uncoupling of bone formation and bone resorption processes [1,6,18]. In contrast to some clinical studies [31,32] stating that osteoporosis in AS is mainly located in the axial skeleton, other authors [28,33] have observed that bone loss also occurs in the appendicular skeleton. Several studies [10,23,[34][35][36][37] have shown a significant correlation between the markers of bone turnover, levels of pro-inflammatory cytokines [i.e., IL-6 and tumor necrosis factor (TNF)-α], and acute-phase reactants such as erythrocyte sedimentation rate and C-reactive protein, suggesting that the systemic inflammatory mediators may be involved in the pathogenesis of osteoporosis in patients with AS.…”

Section: Spinal Remodeling In Asmentioning

confidence: 98%

Spinal fractures in patients with ankylosing spondylitis

Leone¹,

Marino²,

Dell'atti³

et al. 2016

Rheumatol Int

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The ankylosed spine is prone to fracture even after minor trauma due to its changed biomechanical properties. The two central features of ankylosing spondylitis (AS) that promote the pathological remodeling of the spine are inflammation and new bone formation. AS is also associated with osteoporosis that is attributed to an uncoupling of the bone formation and bone resorption processes. Therefore, bone resorption occurs and promotes weakening of the spine as well as increased risk of vertebral fractures which can be hugely different in terms of clinical relevance. Even in the presence of symptomatic clinical vertebral fractures, the diagnosis can be overruled by attributing the pain to disease activity. Furthermore, given the highly abnormal structure of the spine, vertebral fracture diagnosis can be difficult on the basis of radiography alone. CT can show the fractures in detail. Magnetic resonance imaging is considered the method of choice for the imaging of spinal cord injuries, and a reasonable option for exclusion of occult fractures undetected by CT. Since it is equally important for radiologists and clinicians to have a common knowledge base rather than a compartmentalized view, the aim of this review article was to provide the required clinical knowledge that radiologists need to know and the relevant radiological semiotics that clinicians require in diagnosing clinically significant injury to the ankylosed spine.

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“…As well known bone turnover markers, OC [26][27][28][29][30][31][32][33][34][35][36][37][38] (supplemental data 2) and ALP 29,32,36,[39][40][41] (supplemental data 3) have been frequently assessed in AS in former studies; however, to our knowledge, they have not yet been evaluated in parallel with other markers in the Wnt signaling pathway. OC expression was similar between AS patients and controls.…”

Section: Discussionmentioning

confidence: 99%

Alteration of Bone Turnover Markers in Canonical Wingless Pathway in Patients With Ankylosing Spondylitis

et al. 2016

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Objectives: This study aims to determine the levels of bone turnover markers in canonical wingless pathway in patients with ankylosing spondylitis (AS) and the correlation with disease activity indexes. Patients and methods:We recruited a total of 43 AS patients (34 males, 8 females; mean age 36.8±9.3 years; range 22 to 62 years) and age-and sex-matched 42 healthy controls (32 males, 10 females; mean age 36.1±9.7; range 24 to 59 years). Serum levels of components of canonical wingless pathway including Dickkopf-1, glycogen synthase kinase-3β, β-catenin, alkaline phosphatase, and osteocalcin were detected using enzymelinked immunosorbent assay method. All patients were assessed in terms of erythrocyte sedimentation rate, C-reactive protein, Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Functional Index, Ankylosing Spondylitis Disease Activity Score, and the modified Stoke's Ankylosing Spondylitis Spine Score. Pearson's correlation test was used to analyze the correlation between serum bone turnover markers and clinical assessment indexes. Results: No significant difference was observed between AS patients and healthy controls for the levels of glycogen synthase kinase-3β, β-catenin, alkaline phosphatase, and osteocalcin, respectively (p>0.05). The level of Dickkopf-1 was significantly higher in AS patients (1914.5±407.8 pg/mL) than in healthy controls (1729.1±352.9 pg/mL) (p<0.05). There was no correlation between high Dickkopf-1 level and any of the clinical parameters contributing to inflammation or bone formation. However, the correlation between osteocalcin and disease duration was significant in AS patients (r=0.323, p=0.034). Conclusion: Alteration of bone turnover markers in canonical wingless pathway was observed in AS. This might partially explain the complicated mechanism of bone formation in the disease.

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Is Osteoporosis Generalized or Localized to Central Skeleton in Ankylosing Spondylitis?

Cited by 28 publications

References 22 publications

Relationship of bone mineral density with disease activity and functional ability in patients with ankylosing spondylitis: a cross-sectional study

Relationship of bone mineral density with disease activity and functional ability in patients with ankylosing spondylitis: a cross-sectional study

Spinal fractures in patients with ankylosing spondylitis

Alteration of Bone Turnover Markers in Canonical Wingless Pathway in Patients With Ankylosing Spondylitis

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