Factors relating to bone mineral density in young and middle-aged patients with ankylosing spondylitis

Abstract

Background: 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. Methods: 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. Results: 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. Conclusions: 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.

Current health resources required for the management of ankylosing spondylitis in developing areas of China

“…There are some shortcomings in the present study, including (1) This study lacks the transportation used by patients, which only investigated the distance between primary hospitals and the city center; (2) Patients receiving non-steroidal anti-inflammatory drugs and sulfasalazine is not included in this study due to difficulties in obtaining information about their previous medication; (3) Due to inadequate training of primary hospitals' doctors in AS history collection, physical examination, and condition assessment, information about AS characteristics is incomplete in this study; (4) The current evaluation indicators of this study are incomprehensive and less convincing to reflect the diagnosis and treatment level of primary hospitals' doctors, the diagnostic accuracy rate, treatment efficiency, and other indicators should be included for comprehensive evaluation.…”

“…In China, the prevalence of AS is about 0.29% with a male to female ratio of approximately 3:1, and most cases occur in the adolescent period. [ 1 ] The misdiagnosis rate of AS patients in China is >50%, and the average delay time of diagnosis is >7 years. Without standardized treatment, the 3-year disability rate of AS patients can reach 45.5%, and the 5-year disability rate can reach 70%.…”

“…To the Editor : Ankylosing spondylitis (AS) is a chronic inflammatory disease that causes bony fusion of spine and sacroiliac joints, resulting in restricted spinal movement and deformity. In China, the prevalence of AS is about 0.29% with a male to female ratio of approximately 3:1, and most cases occur in the adolescent period [1] . The misdiagnosis rate of AS patients in China is >50%, and the average delay time of diagnosis is >7 years.…”

Immune mechanism of low bone mineral density caused by ankylosing spondylitis based on bioinformatics and machine learning

“…Recent studies on the mechanism of LBMD caused by AS have focused on immunity and inflammation. There was a significant correlation between LBMD and bone turnover markers, osteoprotegerin, proinflammatory cytokines, and acute phase reactants such as CRP and ESR in AS patients, suggesting that inflammatory mediators may be involved in the pathogenesis of LBMD in AS (Kim et al, 2006;Ranganathan et al, 2017;Wu et al, 2021;Rademacher et al, 2022). It has been demonstrated that cytokines, such as IL-6 and TNF, play a vital role in AS inflammation and may be involved in bone destruction in AS (Lee et al, 2022;Rademacher et al, 2022).…”

Chemical Shift-Encoded MRI of Bone Metabolic Markers in Ankylosing Spondylitis

“…Ankylosing spondylitis (AS) is a chronic spondyloarthropathy that occurs frequently in adolescents, with insidious onset and relapsing nature, characterizing irreversible pathological progressive disease from inflammation, bone destruction to the formation of new bone [ 1 , 2 ]. Bone formation may occur in parallel with bone mineral content loss in AS [ 3 , 4 ]. Syndesmophyte formation and progressive ankylosis as well as fracture caused by bone loss are main causes of disability.…”