APPEARANCE OF OSTEOPOROSIS IN FEMALE PATIENTS WITH ANKYLOSING SPONDYLITIS

Background: Spontan spine fractures connected with ankylosing spondylitis (AS) are known to exist. Such fractures might easily escape observation as they may occur without a significant intensifications of pains which permanently torture the AS patients. The presence of inflammatory citokines and the defensive immobil-ity evoked by the pains may lead to an increased bone resorbtion and decreasing bone mineral density (BMD) values signaling the development of osteoporosis (OP).Objectives: In our study we have aimed was to investigate the possible correlation between the occurrence of AS and OP, considering the duration of the malady and the actual mobility of the spine. Extensive BMD and X-ray measurements were carried out also to determine which parameters provide the most pronounced correlation with the manifestation of OP.Methods: For 50 female patients (age range: 25-84 years, 18 of them in post-menopausa) with AS the following characteristics were studied: the early and present complaints and symptoms, the functional state (BASFI) and activity (BASDAI) of the illness, the spine mobility, the OP risk factors (recorded by a questionnair). The OP diagnostics was based on BMD measurements performed on the lumbal spine, on the femoral neck and on the heel. X-ray pictures were taken on the lumbal spine and on the sacroiliac joints. Labora-tory investigations included the study of the Ca-household (Serum-Ca, P, AP, CN, kreatin, urin-Ca and P, furthermore, CRP, TSH, PTH), that of the bone turnover (Osteocalcin and the crosslinks BetaCrossLaps). The possibility of OP of different origin was excluded.Results: Our laboratory data have revealed that most patients have exhibited increased bone resorbtion. The BMD values y show a progress of AS in the form of a linear decrease with age x, determined for the lumbal spine as y = – 0.009x + 1.4147 (with R2=0.383) and for the femoral neck as y = – 0.007x + 1.1522 (with R2=0.4091) indicating the setup of secondary OP. The BUA and SOS values determined for the heel also show a decrease with increasing age and a progress of AS. For female patients, no discrepancy between the behaviours determined for the spine and femoral neck BMD values was found like it was reported for male patients earlier.Conclusion: Our data show that there is a correlation between the activity of AS and the severity of the secondary OP of AS patients and the decreasing BMD values clearly indicate the pathology of this process. The similar tendency found for the heel BUA and SOS is in agreement with the above conclusion. The finding that this decrease with progressing age was found both for the lunbal spine and the femoral neck BMD values as well for female patients -in contrast to the earlier results reported for male patients-could be explained by the relative absence of the calcification of the ligaments for the female patients.Citation: , volume , supplement , year 2003, page Session: Osteoporosis – Clinical aspects and treatment 2