Shin-Hee Kim1, Ki Hwan Kim1, Moon-Young Kim2, Yeon Sik Hong2, Kwi Young Kang3. 1. Department of Pediatrics, College of Medicine, The Catholic University of Korea and Incheon St. Mary's Hospital, Incheon, South Korea. 2. Division of Rheumatology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea and Incheon St. Mary's Hospital, No. 56, Dongsu-Ro, Incheon, South Korea. 3. Division of Rheumatology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea and Incheon St. Mary's Hospital, No. 56, Dongsu-Ro, Incheon, South Korea. kykang@catholic.ac.kr.
Abstract
PURPOSE: Axial spondyloarthritis (axSpA) is a chronic inflammatory disease that primarily affects the axial skeleton and typically has an early onset. Although earlier onset is associated with worse prognosis, there have been few studies of bone mineral density (BMD) in adolescent patients with axSpA. METHODS: We analysed the clinical characteristics of 43 adolescent patients with axSpA at a baseline assessment and at a follow-up 2 years later. The baseline assessment included age, disease duration, treatment agents, and clinical, radiologic, and laboratory data. BMD of the lumbar spine, femoral neck, and total hip were measured by dual-energy X-ray absorptiometry during both the baseline assessment and the 2-year follow-up. We performed multivariate linear regression analyses to identify factors independently associated with BMD. We analysed the associations between changes in BMD and reductions in inflammatory markers. RESULTS: The average age of participants was 17.9 years and the mean disease duration was 2.2 years. Of the 43 patients, 10 (23%) had low BMD at any site (lumbar spine, femoral neck, and/or total hip). At baseline, multivariate analysis showed that body mass index (BMI), erythrocyte sedimentation rate (ESR), and spinal structural damage were associated with lumbar spine Z-scores. Increases in BMD in the lumbar spine were correlated with reductions in ESR (r = 0.40, P = 0.02) and C-reactive protein (CRP) (r = 0.40, P = 0.02). Increases in BMD in the total hip were correlated with reductions in CRP (r = 0.38, P = 0.03). CONCLUSION: In adolescent axSpA patients, bone health was associated with systemic inflammation and the severity of structural damage. Reduced systemic inflammation was associated with improvements in bone health.
PURPOSE: Axial spondyloarthritis (axSpA) is a chronic inflammatory disease that primarily affects the axial skeleton and typically has an early onset. Although earlier onset is associated with worse prognosis, there have been few studies of bone mineral density (BMD) in adolescent patients with axSpA. METHODS: We analysed the clinical characteristics of 43 adolescent patients with axSpA at a baseline assessment and at a follow-up 2 years later. The baseline assessment included age, disease duration, treatment agents, and clinical, radiologic, and laboratory data. BMD of the lumbar spine, femoral neck, and total hip were measured by dual-energy X-ray absorptiometry during both the baseline assessment and the 2-year follow-up. We performed multivariate linear regression analyses to identify factors independently associated with BMD. We analysed the associations between changes in BMD and reductions in inflammatory markers. RESULTS: The average age of participants was 17.9 years and the mean disease duration was 2.2 years. Of the 43 patients, 10 (23%) had low BMD at any site (lumbar spine, femoral neck, and/or total hip). At baseline, multivariate analysis showed that body mass index (BMI), erythrocyte sedimentation rate (ESR), and spinal structural damage were associated with lumbar spine Z-scores. Increases in BMD in the lumbar spine were correlated with reductions in ESR (r = 0.40, P = 0.02) and C-reactive protein (CRP) (r = 0.40, P = 0.02). Increases in BMD in the total hip were correlated with reductions in CRP (r = 0.38, P = 0.03). CONCLUSION: In adolescent axSpA patients, bone health was associated with systemic inflammation and the severity of structural damage. Reduced systemic inflammation was associated with improvements in bone health.
Entities:
Keywords:
Adolescent; Axial spondyloarthritis; Bone health
Authors: Ross E Petty; Taunton R Southwood; Prudence Manners; John Baum; David N Glass; Jose Goldenberg; Xiaohu He; Jose Maldonado-Cocco; Javier Orozco-Alcala; Anne-Marie Prieur; Maria E Suarez-Almazor; Patricia Woo Journal: J Rheumatol Date: 2004-02 Impact factor: 4.666