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Bone microarchitecture in ankylosing spondylitis and the association with bone mineral density, fractures, and syndesmophytes

Klingberg, Eva; Lorentzon, Mattias; Göthlin, Jan; Mellström, Dan; Geijer, Mats LU ; Ohlsson, Claes; Atkinson, Elizabeth J; Khosla, Sundeep; Carlsten, Hans and Forsblad-d'Elia, Helena (2013) In Arthritis Research & Therapy 15(6). p.179-179
Abstract

INTRODUCTION: Osteoporosis of the axial skeleton is a known complication of ankylosing spondylitis (AS), but bone loss affecting the peripheral skeleton is less studied. This study on volumetric bone mineral density (vBMD) and bone microarchitecture in AS was conducted to compare peripheral vBMD in AS patients with that in healthy controls, to study vBMD in axial compared with peripheral bone, and to explore the relation between vertebral fractures, spinal osteoproliferation, and peripheral bone microarchitecture and density.

METHODS: High-resolution peripheral quantitative computed tomography (HRpQCT) of ultradistal radius and tibia and QCT and dual-energy x-ray absorptiometry (DXA) of lumbar spine were performed in 69 male AS... (More)

INTRODUCTION: Osteoporosis of the axial skeleton is a known complication of ankylosing spondylitis (AS), but bone loss affecting the peripheral skeleton is less studied. This study on volumetric bone mineral density (vBMD) and bone microarchitecture in AS was conducted to compare peripheral vBMD in AS patients with that in healthy controls, to study vBMD in axial compared with peripheral bone, and to explore the relation between vertebral fractures, spinal osteoproliferation, and peripheral bone microarchitecture and density.

METHODS: High-resolution peripheral quantitative computed tomography (HRpQCT) of ultradistal radius and tibia and QCT and dual-energy x-ray absorptiometry (DXA) of lumbar spine were performed in 69 male AS patients (NY criteria). Spinal radiographs were assessed for vertebral fractures and syndesmophyte formation (mSASSS). The HRpQCT measurements were compared with the measurements of healthy controls.

RESULTS: The AS patients had lower cortical vBMD in radius (P = 0.004) and lower trabecular vBMD in tibia (P = 0.033), than did the controls. Strong correlations were found between trabecular vBMD in lumbar spine, radius (rS = 0.762; P < 0.001), and tibia (rS = 0.712; P < 0.001). When compared with age-matched AS controls, patients with vertebral fractures had lower lumbar cortical vBMD (-22%; P = 0.019), lower cortical cross-sectional area in radius (-28.3%; P = 0.001) and tibia (-24.0%; P = 0.013), and thinner cortical bone in radius (-28.3%; P = 0.001) and tibia (-26.9%; P = 0.016). mSASSS correlated negatively with trabecular vBMD in lumbar spine (rS = -0.620; P < 0.001), radius (rS = -0.400; p = 0.001) and tibia (rS = -0.475; p < 0.001) and also with trabecular thickness in radius (rS = -0.528; P < 0.001) and tibia (rS = -0.488; P < 0.001). Adjusted for age, syndesmophytes were significantly associated with decreasing trabecular vBMD, but increasing cortical vBMD in lumbar spine, but not with increasing cortical thickness or density in peripheral bone. Estimated lumbar vBMD by DXA correlated with trabecular vBMD measured by QCT (rS = 0.636; P < 0.001).

CONCLUSIONS: Lumbar osteoporosis, syndesmophytes, and vertebral fractures were associated with both lower vBMD and deteriorated microarchitecture in peripheral bone. The results indicate that trabecular bone loss is general, whereas osteoproliferation is local in AS.

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keywords
Absorptiometry, Photon, Adolescent, Adult, Aged, Bone Density, Bone and Bones, Cross-Sectional Studies, Humans, Male, Middle Aged, Radius, Spinal Fractures, Spondylitis, Ankylosing, Tibia, Tomography, X-Ray Computed, Young Adult, Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't
in
Arthritis Research & Therapy
volume
15
issue
6
pages
179 - 179
publisher
BioMed Central
external identifiers
  • scopus:84887076729
  • wos:000330628800005
ISSN
1478-6354
DOI
10.1186/ar4368
language
English
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yes
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bb5bcfa0-a725-4514-bbd1-0ff6a7237b28
date added to LUP
2017-02-21 12:42:01
date last changed
2018-06-24 05:10:38
@article{bb5bcfa0-a725-4514-bbd1-0ff6a7237b28,
  abstract     = {<p>INTRODUCTION: Osteoporosis of the axial skeleton is a known complication of ankylosing spondylitis (AS), but bone loss affecting the peripheral skeleton is less studied. This study on volumetric bone mineral density (vBMD) and bone microarchitecture in AS was conducted to compare peripheral vBMD in AS patients with that in healthy controls, to study vBMD in axial compared with peripheral bone, and to explore the relation between vertebral fractures, spinal osteoproliferation, and peripheral bone microarchitecture and density.</p><p>METHODS: High-resolution peripheral quantitative computed tomography (HRpQCT) of ultradistal radius and tibia and QCT and dual-energy x-ray absorptiometry (DXA) of lumbar spine were performed in 69 male AS patients (NY criteria). Spinal radiographs were assessed for vertebral fractures and syndesmophyte formation (mSASSS). The HRpQCT measurements were compared with the measurements of healthy controls.</p><p>RESULTS: The AS patients had lower cortical vBMD in radius (P = 0.004) and lower trabecular vBMD in tibia (P = 0.033), than did the controls. Strong correlations were found between trabecular vBMD in lumbar spine, radius (rS = 0.762; P &lt; 0.001), and tibia (rS = 0.712; P &lt; 0.001). When compared with age-matched AS controls, patients with vertebral fractures had lower lumbar cortical vBMD (-22%; P = 0.019), lower cortical cross-sectional area in radius (-28.3%; P = 0.001) and tibia (-24.0%; P = 0.013), and thinner cortical bone in radius (-28.3%; P = 0.001) and tibia (-26.9%; P = 0.016). mSASSS correlated negatively with trabecular vBMD in lumbar spine (rS = -0.620; P &lt; 0.001), radius (rS = -0.400; p = 0.001) and tibia (rS = -0.475; p &lt; 0.001) and also with trabecular thickness in radius (rS = -0.528; P &lt; 0.001) and tibia (rS = -0.488; P &lt; 0.001). Adjusted for age, syndesmophytes were significantly associated with decreasing trabecular vBMD, but increasing cortical vBMD in lumbar spine, but not with increasing cortical thickness or density in peripheral bone. Estimated lumbar vBMD by DXA correlated with trabecular vBMD measured by QCT (rS = 0.636; P &lt; 0.001).</p><p>CONCLUSIONS: Lumbar osteoporosis, syndesmophytes, and vertebral fractures were associated with both lower vBMD and deteriorated microarchitecture in peripheral bone. The results indicate that trabecular bone loss is general, whereas osteoproliferation is local in AS.</p>},
  author       = {Klingberg, Eva and Lorentzon, Mattias and Göthlin, Jan and Mellström, Dan and Geijer, Mats and Ohlsson, Claes and Atkinson, Elizabeth J and Khosla, Sundeep and Carlsten, Hans and Forsblad-d'Elia, Helena},
  issn         = {1478-6354},
  keyword      = {Absorptiometry, Photon,Adolescent,Adult,Aged,Bone Density,Bone and Bones,Cross-Sectional Studies,Humans,Male,Middle Aged,Radius,Spinal Fractures,Spondylitis, Ankylosing,Tibia,Tomography, X-Ray Computed,Young Adult,Journal Article,Research Support, N.I.H., Extramural,Research Support, Non-U.S. Gov't},
  language     = {eng},
  number       = {6},
  pages        = {179--179},
  publisher    = {BioMed Central},
  series       = {Arthritis Research & Therapy},
  title        = {Bone microarchitecture in ankylosing spondylitis and the association with bone mineral density, fractures, and syndesmophytes},
  url          = {http://dx.doi.org/10.1186/ar4368},
  volume       = {15},
  year         = {2013},
}