Top

Published in:

Open Access 01-12-2011 | Research article

Baseline new bone formation does not predict bone loss in ankylosing spondylitis as assessed by quantitative computed tomography (QCT) - 10-year follow-up

Authors: Mariusz Korkosz, Jerzy Gąsowski, Piotr Grzanka, Janusz Gorczowski, Wojciech Pluskiewicz, Sławomir Jeka, Tomasz Grodzicki

Published in: BMC Musculoskeletal Disorders | Issue 1/2011

Abstract

Background

To evaluate the relationship between bone loss and new bone formation in ankylosing spondylitis (AS) using 10-year X-ray, dual-energy x-ray absorptiometry (DXA) and quantitative computed tomography (QCT) follow-up.

Methods

Fifteen AS patients free from medical conditions and drugs affecting bone metabolism underwent X-ray, DXA and QCT in 1999 and 2009.

Results

In spine QCT a statistically significant (p = 0,001) decrease of trabecular bone mineral content (BMC) was observed (change ± SD: 18.0 ± 7.3 mg/cm³). In contrast, spine DXA revealed a significant increase of bone mineral density (change ± SD: -0.15 ± 0.14 g/cm²). The mean BMC, both at baseline and follow-up was significantly lower (p = 0.02 and p = 0.005, respectively) in advanced radiological group as compared to early radiological group. However, in multiple regression model after adjustment for baseline BMC, the baseline radiological scoring did not influence the progression of bone loss as assessed with QCT (p = 0.22, p for BMC*X-ray syndesmophyte scoring interaction = 0.65, p for ANOVA-based X-ray syndesmophyte scoring*time interaction = 0.39). Baseline BMC was the only significant determinant of 10-year BMC change, to date the longest QCT follow-up data in AS.

Conclusions

In AS patients who were not using antiosteoporotic therapy spine trabecular bone density evaluated by QCT decreased over 10-year follow-up and was not related to baseline radiological severity of spine involvement.

Available only for authorised users

Gratacos J, Collado A, Pons F, Osaba M, Sanmarti R, Roque M: Significant loss of bone mass in patients with early, active ankylosing spondylitis: A followup study. Arthritis Rheum. 1999, 42 (11): 2319-24. 10.1002/1529-0131(199911)42:11<2319::AID-ANR9>3.0.CO;2-G.CrossRefPubMed

Maillefert JF, Aho LS, El Maghraoui A, Dougados M, Roux C: Changes in bone density in patients with ankylosing spondylitis: A two-year follow-up study. Osteoporos Int. 2001, 12 (7): 605-9. 10.1007/s001980170084.CrossRefPubMed

Donnelly S, Doyle DV, Denton A, Rolfe I, McCloskey EV, Spector TD: Bone mineral density and vertebral compression fracture rates in ankylosing spondylitis. Ann Rheum Dis. 1994, 53 (2): 117-21. 10.1136/ard.53.2.117.CrossRefPubMedPubMedCentral

Mitra D, Elvins DM, Speden DJ, Collins AJ: The prevalence of vertebral fractures in mild ankylosing spondylitis and their relationship to bone mineral density. Rheumatology (Oxford). 2000, 39 (1): 85-9. 10.1093/rheumatology/39.1.85.CrossRef

Lange U, Kluge A, Strunk J: Ankylosing spondylitis and bone mineral density - what is the ideal tool for measurement?. Rheumatol Int. 2005, 26: 115-20. 10.1007/s00296-004-0515-4.CrossRefPubMed

Karberg K, Zochling J, Sieper J, Felsenberg D, Braun J: Bone loss is detected more frequently in patients with ankylosing spondylitis with syndesmophytes. J Rheumatol. 2005, 32 (7): 1290-8.PubMed

Korkosz M, Gluszko P, Marcinek P: Comment on bone mineral density and bone turnover markers in a group of male ankylosing spondylitis patients. J Clin Rheumatol. 2002, 8 (6): 359-60. 10.1097/00124743-200212000-00017.CrossRefPubMed

Kalender WA, Felsenberg D, Louis O, Lopez P, Klotz E, Osteaux M: Reference values for trabecular and cortical vertebral bone density in single and dual-energy quantitative computed tomography. Eur J Radiol. 1989, 9 (2): 75-80.PubMed

Devogelaer JP, Maldague B, Malghem J, Nagant de Deuxchaisnes C: Appendicular and vertebral bone mass in ankylosing spondylitis. A comparison of plain radiographs with single- and dual-photon absorptiometry and with quantitative computed tomography. Arthritis Rheum. 1992, 35 (9): 1062-7. 10.1002/art.1780350911.CrossRefPubMed

10.

Cooper C, Carbone L, Michet CJ, Atkinson EJ, O'Fallon WM, Melton LJ: Fracture risk in patients with ankylosing spondylitis: A population based study. J Rheumatol. 1994, 21 (10): 1877-82.PubMed

11.

Vosse D, Landewe R, van der Heijde D, van der Linden S, van Staa TP, Geusens P: Ankylosing spondylitis and the risk of fracture: Results from a large primary care-based nested case-control study. Ann Rheum Dis. 2009, 68 (12): 1839-42. 10.1136/ard.2008.100503.CrossRefPubMed

12.

Grampp S, Genant HK, Mathur A, Lang P, Jergas M, Takada M: Comparisons of noninvasive bone mineral measurements in assessing age-related loss, fracture discrimination, and diagnostic classification. J Bone Miner Res. 1997, 12 (5): 697-711. 10.1359/jbmr.1997.12.5.697.CrossRefPubMed

13.

Kroger H, Lunt M, Reeve J, Dequeker J, Adams JE, Birkenhager JC: Bone density reduction in various measurement sites in men and women with osteoporotic fractures of spine and hip: The european quantitation of osteoporosis study. Calcif Tissue Int. 1999, 64 (3): 191-9. 10.1007/s002239900601.CrossRefPubMed

14.

Lang TF, Guglielmi G, van Kuijk C, De Serio A, Cammisa M, Genant HK: Measurement of bone mineral density at the spine and proximal femur by volumetric quantitative computed tomography and dual-energy X-ray absorptiometry in elderly women with and without vertebral fractures. Bone. 2002, 30 (1): 247-50. 10.1016/S8756-3282(01)00647-0.CrossRefPubMed

15.

Lee YS, Schlotzhauer T, Ott SM, van Vollenhoven RF, Hunter J, Shapiro J: Skeletal status of men with early and late ankylosing spondylitis. Am J Med. 1997, 103 (3): 233-41. 10.1016/S0002-9343(97)00143-5.CrossRefPubMed

16.

Mullaji AB, Upadhyay SS, Ho EK: Bone mineral density in ankylosing spondylitis. DEXA comparison of control subjects with mild and advanced cases. J Bone Joint Surg Br. 1994, 76 (4): 660-5.PubMed

17.

Will R, Palmer R, Bhalla AK, Ring F, Calin A: Osteoporosis in early ankylosing spondylitis: A primary pathological event?. Lancet. 1989, 23-30;2 (8678-8679): 1483-5.CrossRef

18.

El Maghraoui A, Borderie D, Cherruau B, Edouard R, Dougados M, Roux C: Osteoporosis, body composition, and bone turnover in ankylosing spondylitis. J Rheumatol. 1999, 26 (10): 2205-9.PubMed

19.

Lange U, Teichmann J, Strunk J, Muller-Ladner U, Schmidt KL: Association of 1.25 vitamin D3 deficiency, disease activity and low bone mass in ankylosing spondylitis. Osteoporos Int. 2005, 16 (12): 1999-2004. 10.1007/s00198-005-1990-5.CrossRefPubMed

20.

Toussirot E, Ricard-Blum S, Dumoulin G, Cedoz JP, Wendling D: Relationship between urinary pyridinium cross-links, disease activity and disease subsets of ankylosing spondylitis. Rheumatology (Oxford). 1999, 38 (1): 21-7. 10.1093/rheumatology/38.1.21.CrossRef

21.

Allali F, Breban M, Porcher R, Maillefert JF, Dougados M, Roux C: Increase in bone mineral density of patients with spondyloarthropathy treated with anti-tumour necrosis factor alpha. Ann Rheum Dis. 2003, 62 (4): 347-9. 10.1136/ard.62.4.347.CrossRefPubMedPubMedCentral

22.

Mitra D, Elvins DM, Collins AJ: Biochemical markers of bone metabolism in mild ankylosing spondylitis and their relationship with bone mineral density and vertebral fractures. J Rheumatol. 1999, 26 (10): 2201-4.PubMed

23.

Grisar J, Bernecker PM, Aringer M, Redlich K, Sedlak M, Wolozcszuk W: Ankylosing spondylitis, psoriatic arthritis, and reactive arthritis show increased bone resorption, but differ with regard to bone formation. J Rheumatol. 2002, 29 (7): 1430-6.PubMed

24.

Sieper J: Can structural damage be prevented in ankylosing spondylitis?. Curr Opin Rheumatol. 2009, 21 (4): 335-9. 10.1097/BOR.0b013e32832c668a.CrossRefPubMed

25.

Appel H, Janssen L, Listing J, Heydrich R, Rudwaleit M, Sieper J: Serum levels of biomarkers of bone and cartilage destruction and new bone formation in different cohorts of patients with axial spondyloarthritis with and without tumor necrosis factor-alpha blocker treatment. Arthritis Res Ther. 2008, 10 (5): R125-10.1186/ar2537.CrossRefPubMedPubMedCentral

The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2474/12/121/prepub

Title: Baseline new bone formation does not predict bone loss in ankylosing spondylitis as assessed by quantitative computed tomography (QCT) - 10-year follow-up
Authors: Mariusz Korkosz
Jerzy Gąsowski
Piotr Grzanka
Janusz Gorczowski
Wojciech Pluskiewicz
Sławomir Jeka
Tomasz Grodzicki
Publication date: 01-12-2011
Publisher: BioMed Central
Published in: BMC Musculoskeletal Disorders / Issue 1/2011
Electronic ISSN: 1471-2474
DOI: https://doi.org/10.1186/1471-2474-12-121

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Baseline new bone formation does not predict bone loss in ankylosing spondylitis as assessed by quantitative computed tomography (QCT) - 10-year follow-up

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2011

Erratum to: The effect of a sports chiropractic manual therapy intervention on the prevention of back pain, hamstring and lower limb injuries in semi-elite Australian Rules footballers: A randomized controlled trial

Longitudinal Numbers-Needed-To-Treat (NNT) for Achieving Various Levels of Analgesic Response and Improvement with Etoricoxib, Naproxen, and Placebo in Ankylosing Spondylitis

Adalimumab reduces hand bone loss in rheumatoid arthritis independent of clinical response: Subanalysis of the PREMIER study

Mortality and cause of death in hip fracture patients aged 65 or older - a population-based study

Biochemical comparison of osteoarthritic knees with and without effusion

Gene expression profile of the cartilage tissue spontaneously regenerated in vivo by using a novel double-network gel: Comparisons with the normal articular cartilage