OSOBENNOSTI METABOLIZMA KOSTNOY TKANI U BOL'NYKh ANKILOZIRUYuShchIM SPONDILOARTRITOM

Abstract


Objective: To define the specific features of bone metabolism and to estimate bone mineral density (BMD) in patients with ankylosing spondylitis (AS) Subjects and methods: Seventy-two patients (66 males and 6 females) with SA were examined. Markers of bone metabolism markers were assessed, by measuring the serum levels of osteocalcin (OC) and C-terminal telopeptides (bCrosslaps) by enzyme-linked immunoassay. Bone mineral density (BMD) was studied by distal forearm by dual-energy X-ray absorptiometry (DEXA) on a DexaScan DX-10 apparatus. BMD was estimated in women and men older 50 years by the T-test and in men under 50 years by the Z-test. Results: Low BMD was found by DEXA in 55% patients with SA., 7% patients had a vertebral fracture. The level of bCrosslaps was 0.52±0.37 ng/ml (p>0.05) and that of osteocalcin was 12,9±7,1 ng/ml (p<0.05), which is accordingly higher and lower than the reference values. With higher SA activity and advance of X-ray disease stage, there was a tendency for bCrosslaps to increase and osteocalcin to decrease. Correlation analysis revealed a correlation between the value of BMD and the SA activity, between the levels of OC and X-ray disease stage and functional index BASDAI., between the levels of bCrosslaps and degree of activity AS. Age and low physical activity also affected the parameters of BMD in patients with SA.

About the authors

S A Yushina

vrach, zaochnyy aspirant

O V Bugrova

d.m.n., professor

N A Ovchinnikova

vrach

I A Aleksandrova

vrach

References

  1. Бадокин В.В. Медикаментозная терапия анкилозирующего спондилоартрита // Русский медицинский журнал. - 2004. - 20. - C. 1128-1136.
  2. Годзенко А.А. Поражение почек при серонегативных спондилоартритах // Трудный пациент. - 2006. - 7. - С. 46-49.
  3. Заводовский Б.В., Зборовская И.А., Цхададзе Н.Д., Зборовский А.Б. Распространенность остеопении при анкилозирующем спондилоартрите и её коррекция альфакальцидолом // Научно-практическая ревматологияю - 2005. - 1. - С. 271-287.
  4. Насонов Е.Л. Клинические рекомендации по ревматологии. М: «ГЭОТАР-Медиа», 2010. - С. 72-85.
  5. Насонов Е.Л., Скрипникова И.А., Насонова В.А. Проблема остеопороза в ревматологии. М.: «СТИН», 1997. - С. 357-358.
  6. Остеопороз. Клинические рекомендации / под редакцией О.М. Лесняк, Л.И. Беневоленской. - 2-е издание переработанное и дополненное. - М.: ГЭОТАР-Медиа, 2011. - 272с.
  7. Franck H., Keck E. Serum osteocalcin and vitamin D metabolites in patients with ankylosing spondylitis // Annals of the Rheumatic Diseases - 1993. - 52. - Р. 343-346.
  8. Gratacos J., Collado A., Pons F., et al. Significant loss of bone mass in patients with early, active ankylosing spondylitis // Arthritis & Rheumatism - 2002. - 46 (12). - Р 3390-3392.
  9. Grisar J., Bernecker P.M., Aringer M., et al. Ankylosing spondylitis, psoriatic arthritis, and reactive arthritis show increased bone resorption, but differ with regard to bone formation// J. Rheumatology -2002. - 29(7). - Р. 1430-1436
  10. Karberg K., Zochling J., et al. Bone loss is detected more frequently in patient with ankylosing spondylitis with syndesmophytes // J. Rheumatology - 2005. - 32(7). - Р. 1290-1297.
  11. Kim H.-R., Kim Y.-R., Lee S.-H. Elevated serum levels of soluble receptor activator of nuclear factors-kB ligand (sRANKL) and reduce bone mineral density in patients with ankylosing spondylitis // J. Rheumatology - 2006. - 45 (10). - Р. 1197-1200.
  12. Macdonald A.G., Birkinshaw G., Durham B., Bucknall R.C., Fraser W.D. Biochemical markers of bone turnover in seronegative spondiloartropathy: relationship to disease activity // J. Rheumatology -1997. - 36. - Р. 50-53.
  13. Marhoffer W., Stracke H., Masoud I., et al. Evidence of impaired cartilage/bone turnover in patients with active ankylosing spondylitis // Annals of the Rheumatic Diseases - 1995. - 54. - Р. 556-559.
  14. Mitra D., Elvins D.M., Collins A.J. Biochemical markers of bone metabolism in mild ankylosing spondylitis and their relationship with bone mineral density and vertebral fractures // J. Rheumatology -1999. - 26(10). - Р 2201-2204.
  15. Reid D., Nicoll J., et al. Bone mass in ankylosing spondylitis // J. Rheumatology. - 1996. - 13. - P. 932-935.
  16. Sieper J., Rudwaleit M., Baraliakos X., et al. The Assessment of Spondylo Arthritis international Society (ASAS) handbook: a guide to assess spondyloarthritis. Annals of the Rheumatic Diseases 2009; 68: 1-44.

Statistics

Views

Abstract - 676

PDF (Russian) - 369

Cited-By


PlumX

Dimensions


Copyright (c) 2011 Yushina S.A., Bugrova O.V., Ovchinnikova N.A., Aleksandrova I.A.

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies