Osteoporosis, spinal mobility and chest expansion index in patients with ankylosing spondylitis [Osteoporoza, pokretljivost kralješnice i indeks disanja u bolesnika sa ankilozantnim spondilitisom ]

Grubišić, Frane and Grazio, Simeon and Balenović, Antonija and Nemčić, Tomislav and Kusić, Zvonko (2014) Osteoporosis, spinal mobility and chest expansion index in patients with ankylosing spondylitis [Osteoporoza, pokretljivost kralješnice i indeks disanja u bolesnika sa ankilozantnim spondilitisom ]. Collegium Antropologicum, 38 (1). pp. 63-68. ISSN 0350-6134

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Abstract

To determine the correlation between the bone mineral density (BMD) and spinal mobility and chest expansion index in patients with ankylosing spondylitis. Eighty patients with confirmed diagnosis of ankylosing spondylitis were included in this study. In all of them physical examination was performed including assessment of spinal mobility and chest expansion index. Bone mineral density of the lumbar spine (L1-L4, anteroposterior view) and at the left hip was measured by dual X-ray absorptiometry (DXA) in standard manner According to the WHO classification of osteoporosis, patients were classified in three groups (normal, osteopenic or osteoporotic) depending on the osteoporotic status in lumbar spine, hip and femoral neck region. Eighty patients (46 men and 34 women; age 25-73 years) were included. Mean BMD for lumbar spine was 1.104 +/- 1.043 (T score: 0.67 +/- 2.15) and for total hip was 1.057 +/- 0.899 (T score: -0.28 +/- 2.34). Significant difference in the mobility of thoracic spine was observed in patients in regard to the WHO classification of osteoporosis in lumbar and femoral region (p = 0.031, Oneway Anova for osteoporosis of lumbar region; p = 0.022, Oneway Anova for osteoporosis of total hip region). Mean value for the chest expansion index was 3.07 +/- 1.66 cm. Chest expansion index was significantly reduced in patients having osteoporosis in lumbar and total hip region (p = 0.015, Oneway Anova for osteoporosis of lumbar region; p = 0.038, Oneway Anova for osteoporosis of total hip region). The observation that reduced mobility of thoracic and lumbar spine and chest expansion index occured in patients with low BMD in lumbar and total hip region suggest that osteoporosis should be monitored more frequently in patients with AS.

Abstract in Croatian

U radu se želi odrediti postoji korelacija između mineralne gustoće kostiju i pokretljvosti kralješnice i indeksa disanja u bolesnika sa ankilozantnim spondilitisom. Istraživanjem je uključeno osamdeset bolesnika sa potvrđenom dijagnozom ankilozantnog spondilitisa. Klinički pregled bolesnika obuhvatio je mjerenje pokretljivosti kralješnice i indeksa disanja. Mineralna gustoća kosti (MGK) lumbalne kralješnice (L1–L4, anteroposterior pogled) i lijevog kuka mjerene su dvostrukom apsorpciometrijom X zraka standardnim načinom. Temeljem WHO klasifikacije osteoporoze, bolesnici su podijeljeni u tri skupine (normalan, ostepenija ili osteoporoza) ovisno o osteoporotskom statusu u području lumbalne kralješnice, kuka i području vrata femura. Osamdeset bolesnika (46 muškaraca i 24 žene; raspon godina 25–73) uključeni su u istraživanje. Srednja vrijednosti MGK lumbalne kralješnice iznosila je 1,104±1,043 (T vrijednost: 0,67±2,15) i za područje kuka 1,057±0,899 (T vrijednost: –0,28±2,34). Značajna razlika u pokretljivosti torakalne kralješnice uočena je u bolesnika sa osteoporozom lumbalne kralješnice i područja femura obzirom na WHO klasifikaciju (p=0,031, Oneway Anova za osteoporozu u lumbalnoj kralješnici; p=0,022, Oneway Anova za osteoporozu u području kuka). Srednja vrijednost indeksa disanja iznosila je 3,07±1,66 cm. Indeks disanja značajno je smanjen u bolesnika koji imaju osteoporozu u lumbalnoj kralješnici i u području kuka (p=0,015, Oneway Anova za osteoporozu u lumbalnoj kralješnici; p=0,038, Oneway Anova za osteoporozu u području kuka). Budući da je u bolesnika sa smanjenom MGK u slabinskoj kralješnici i u području kuka uočena ograničena pokretljivost torakalne i lumbalne kralješnice i indeksa disanja, u bolesnika sa ankilozantnim spondilitisom osteoporozu bi se trebalo češće detektirati.

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