Abstract
BackgroundIn the present study, we investigated bone geometry, microstructure, and volumetric bone mineral density (vBMD) in a cohort of patients with nonradiographic axial spondyloarthritis (nr-axSpA) in order to define the early bone changes occurring in axial spondyloarthritis (axSpA) and to define potential factors for deterioration of bone microstructure.MethodsPatients with axSpA (n = 107) and healthy control subjects (n = 50) of similar age and sex were assessed for geometric, volumetric, and microstructural parameters of bone using high-resolution peripheral quantitative computed tomography (HR-pQCT) at the radius. Additionally, demographic and disease-specific characteristics of patients with axSpA were recorded.ResultsPatients with nr-axSpA and control subjects were comparable in age, sex, and body mass index. Geometric and microstructural analysis by HR-pQCT revealed a significantly reduced cortical area (p = 0.022) and cortical thickness (p = 0.006) in patients with nr-axSpA compared with control subjects. Total and cortical vBMD were significantly reduced in patients with nr-axSpA (p = 0.042 and p = 0.007, respectively), whereas there was no difference in trabecular vBMD. Patients with a short disease duration (< 2 years; n = 46) also showed significant reduction of cortical thickness and cortical area compared with control subjects. Patients with disease duration > 2 years (n = 55) additionally developed a decrease of cortical and total vBMD. Multiple regression models identified male sex to be associated with lower cortical vBMD and female sex to be associated with lower trabecular vBMD.ConclusionsBone microstructure in patients with nr-axSpA is characterized primarily by deterioration of cortical bone. Cortical bone loss starts early and is evident within the first 2 years of the disease.
Highlights
In the present study, we investigated bone geometry, microstructure, and volumetric bone mineral density in a cohort of patients with nonradiographic axial spondyloarthritis in order to define the early bone changes occurring in axial spondyloarthritis and to define potential factors for deterioration of bone microstructure
Characteristics of patients with nr-axial spondyloarthritis (axSpA) and healthy control subjects A total of 107 patients with nr-axSpA and 50 healthy control subjects were recruited for this bone analysis
Patients with nr-axSpA and control subjects were comparable in age, sex, and Body mass index (BMI)
Summary
We investigated bone geometry, microstructure, and volumetric bone mineral density (vBMD) in a cohort of patients with nonradiographic axial spondyloarthritis (nr-axSpA) in order to define the early bone changes occurring in axial spondyloarthritis (axSpA) and to define potential factors for deterioration of bone microstructure. Axial disease comprises nonradiographic axial SpA (nr-axSpA) and ankylosing spondylitis (AS). Authors of a recent review of the literature on bone mass in AS reported a prevalence of osteoporosis varying from 3% to 47% according to different measurement techniques and patient selection criteria, whereas osteopenia has been reported in up to 88% of patients [2]. These variations may be based on the fact that bone analysis in nr-axSpA and AS is challenging, in the axial skeleton, where it is confounded by local new bone formation. In patients with syndesmophytes, dual-energy X-ray absorptiometry (DXA) is unreliable because it sums up new bone formation with bone loss owing to its two-dimensional nature [3, 4]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
