THE EFFECT OF DISEASE ACTIVITY AND HORMONAL FACTORS ON BONE MINERAL DENSITY IN MALE PATIENTS WITH ANKYLOSING SPONDYLITIS

Yıl 2013, Cilt: 76 Sayı: 3, 44 - 48, 30.09.2013

Ayten Yazıcı Ayşe Çefle Ahmet Eminler Hakan Demir

Öz

Objectives: Osteoporosis is a common complication of ankylosing spondylitis (AS) and various factors may cause a reduction in bone mineral density (BMD).

Methods: In this study, the frequency of osteoporosis and the relationship between BMD and disease activity (BASDAI), functional status (BASFI), age, disease duration, body mass index (BMI), calcium, phosphorus, alkaline phosphatase, erythrocyte sedimentation rate, CRP, ferritin, intact parathyroid hormone, sex and thyroid hormones were investigated. Thirty four men with AS (mean age:35.4±10.7; mean disease duration:5.2±5.6 years) were enrolled.

Results: The measurement of lumbar spine and/or femoral neck BMD was under -2.5 SD in 13 patients (38.2%). Osteopenia or osteoporosis was detected at lumbar region in 19 patients (55.9%), and at femoral neck in 10 cases (29.4%). The values of BMD T-score were found -1.44±1.76 for lumbar spine, and -0.24±1.35 for femoral neck. Negative correlation was found between DHEA-S and lumbar T-score (r=-0.44, p=0.013) and lumbar Z-score (r=-0.58, p=0.003). Positive correlation was found between lumbar Z-score and estradiol (r=0.45, p=0.029) and homocysteine (r=0.68, p=0.004). For presence of osteoporosis, there was a positive correlation with DHEA-S (r=0.44, p=0.011), and negative correlation with estradiol (r=-0.39, p=0.029). When looking at the correlation between disease activity and osteoporosis, there was only negative correlation between BASFI and femoral neck Z-score (r=-0.47, p=0.027), and positive correlation between BASDAI and the presence of osteoporosis (r=0.40, p=0.025).

Conclusion: Osteoporosis is a common complication of young men with AS. Further studies are required to determine the factors that contribute to a reduction of bone density in AS.

Anahtar Kelimeler

Ankylosing spondylitis, osteoporosis, bone mineral density.

ANKİLOZAN SPONDİLİTLİ ERKEK HASTALARDA HASTALIK AKTİVİTESİ VE HORMONAL FAKTÖRLERİN KEMİK MİNERAL YOĞUNLUĞU ÜZERİNE ETKİSİ

Öz

Amaç: Osteoporoz ankilozan spondilitin (AS) sık rastlanan bir komplikasyonudur ve çeşitli faktörler kemik mineral yoğunluğunda (KMY) azalmaya neden olabilmektedir.

Yöntem: Bu çalışmada; AS’li hastalarda osteoporoz sıklığı ve KMY’deki azalma ile hastalık aktivitesi (BASDAI), fonksiyonel durum (BASFI), yaş, hastalık süresi, beden kitle indeksi (BKİ), kalsiyum, fosfor, alkalen fosfataz, eritrosit sedimentasyon hızı, CRP, ferritin, intakt parathormon, cinsiyet ve tiroid hormonları arasındaki ilişki araştırıldı. AS’li 34 erkek hasta (ortalama yaş: 35,4±10,7; ortalama hastalık süresi: 5,2±5,6 yıl) çalışmaya alındı.

Bulgular: Lomber vertebra ve/veya femur boynu KMY ölçümü 13 hastada (%38,2) -2,5 SD’nin altında idi. Hastaların 19’unda (%55,9) lomber bölgede, 10’unda (%29,4) femur boynunda osteopeni veya osteoporoz saptandı. KMY T-skoru ortalama değerleri lomber vertebra için -1,44±1,76, femur boynu için -0,24±1,35 bulundu. DHEA-S ile lomber T-skoru (r=-0.44, p=0.013) ve lomber Z-skoru (r=-0.58, p=0.003) arasında negatif korelasyon saptandı. Östradiol (r=0.45, p=0.029) ve Homosistein (r=0.68, p=0.004) ile lomber Z-skoru arasında pozitif korelasyon saptandı. Osteoporoz varlığı açısından DHEA-S ile pozitif (r=0.44, p=0.011), östradiol ile negatif (r=-0.39, p=0.029) korelasyon vardı. Hastalık aktivitesi ile osteoporoz arasında korelasyona bakıldığında BASFİ ile femur boynu Z-skoru arasında negatif korelasyon (r=-0.47, p=0.027), osteoporoz varlığı ile BASDAİ arasında ise pozitif korelasyon (r=0.40, p=0.025) olduğu görüldü.

Sonuç: AS’li genç erkeklerde osteoporoz sık görülen bir komplikasyondur. AS’de kemik yoğunluğunda azalmaya katkıda bulunan faktörlerin belirlenmesi için başka çalışmalar gereklidir.

Anahtar Kelimeler

Ankilozan spondilit, osteoporoz, kemik mineral yoğunluğu

Kaynakça

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