Mineralna gustoća kosti u bolesnika sa seronegativnim spondiloartropatijama [Bone mineral density in patients with seronegative spondylarthropathies]

Prutki, Maja (2010) Mineralna gustoća kosti u bolesnika sa seronegativnim spondiloartropatijama [Bone mineral density in patients with seronegative spondylarthropathies]. PhD thesis, Sveučilište u Zagrebu.

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Abstract

Objective. The aim of this study was to analyze bone mineral density (BMD) in patients with seronegative spondylarthropathy, to determine the frequency of osteoporosis, to investigate the relationship between BMD and clinical, laboratory, and radiological variables in patients with seronegative spondyloartropathy, to define the relationship between bone growth (syndesmophytes) and bone loss, and to determine the frequency of vertebral fractures. ----- Methods. 237 patients with seronegative spondyloartropathy (157 women, 80 men) and 100 healthy controls were recruited to the study. Lumbar spine, hip and forearm BMD were measured by dual energy X-ray absorptiometry. Radiographs of the lumbar spine were used to analyze syndesmophytes and vertebral fractures. ----- Results. Compared with age-matched controls, patients with seronegative spondyloartropathy had a significantly lower BMD in the lumbar spine (1,217±0,148 g/cm2 vrs 1,049±0,216 g/cm2) and in the total hip (1,086±0,168 g/cm2 vrs 0,968±0,174 g/cm2), (p<0,001). Osteoporosis was observed in 57 (24,1%) patients. Presence of syndesmophytes and vertebral fractures significantly correlated with BMD. Vertebral fracture was observed in 99 (41,8%) patients. ----- Conclusion. Patients with seronegative spondyloartropathy had lower BMD in comparison with healthy controls. The demineralization was related to the disease duration, low bone mass index, smoking and the number of years since menopause. Bone mass loss in seronegative spondyloartropathy is better evaluated at the femur because syndesmophytes are common finding in this group of patients.

Abstract in Croatian

Svrha rada. Svrha istraživanja je analiza mineralne gustoće kosti (BMD, engl. bone mineral density) kod bolesnika sa seronegativnom spondiloartropatijom, odrediti učestalost osteoporoze, analizirati povezanost BMD-a i kliničkih, laboratorijskih i radioloških čimbenika u toj skupini bolesnika, definirati povezanost između gubitka koštane mase i sindezmofita, i odrediti učestalost vertebralnih prijeloma. ----- Bolesnici i metode. U istraživanje je bilo uključeno 237 bolesnika sa seronegativnom spondiloartropatijom (157 žena i 80 muškaraca) i 100 zdravih ispitanika. BMD lumbalne kralježnice, proksimalnog dijela bedrene kosti i radijusa su određene denzitometrijom dvoenergetskim rendgenskim zrakama. Sindezmofiti i vertebralni prijelomi su analizirani na konvencionalnim snimkama kralježnice. ----- Rezultati. Bolesnici su u usporedbi s kontrolnom skupinom zdravih ispitanika imali značajno niže vrijednosti BMD-a u lumbalnoj kralježnici (1,049±0,216 g/cm2 vrs 1,217±0,148 g/cm2) i bedrenoj kosti (0,968±0,174 g/cm2 vrs 1,086±0,168 g/cm2), (p<0,001). 57 (24,1%) bolesnika je imalo osteoporozu. Učestalost javljanja sindezmofita i prijeloma kralježaka bila je povezana s BMD vrijednostima. 99 (41,8%) bolesnika je imalo prijelom kralješka. ----- Zaključak. BMD je niži u bolesnika sa seronegativnom spondiloartropatijom nego u kontrolnoj skupini zdravih ispitanika. Demineralizacija je bila povezana s duljim trajanjem bolesti, nižim ITM-om, pušenjem i trajanjem menopauze. BMD je bolje procjenjivati na temelju proksimalnog dijela bedrene kosti, jer su sindezmofiti čest nalaz u toj skupini ispitanika.

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