Assessing bone impairment in ankylosing spondylitis (AS) using the trabecular bone score (TBS) and high-resolution peripheral quantitative computed tomography (HR-pQCT)

Objectives: To compare bone quality using the trabecular bone score (TBS) and bone microarchitecture in the distal tibia using high-resolution peripheral quantitative computed tomography (HR-pQCT) in ankylosing spondylitis (AS) patients and healthy controls (HC). Methods: Areal bone mineral density (aBMD) and TBS (TBS iNsight software) were evaluated using DXA (Hologic, QDR 4500); while volumetric bone mineral density (vBMD) and bone microarchitecture were analyzed in the distal tibia using HR-pQCT (Scanco) in 73 male patients with AS and 52 age-matched HC. Results: AS patients were a mean 41.6 +/- 7.9 years old and had a mean disease duration of 16.4 +/- 8.6 y, with a mean mSASSS 25.6 +/- 16.4. No difference was observed in lumbar spine aBMD in AS patients and HC (p = 0.112), but total hip BMD (p = 0.011) and TBS (p < 0.001) were lower in AS patients. In the distal tibia, reduced trabecular volumetric density [Tb.vBMD (p < 0.006)] and structural alterations - trabecular thickness (Tb.Th), p = 0.044 and trabecular separation (Tb.Sp), p = 0.039 - were observed in AS patients relative to controls. Further analysis comparing TBS < 1.310 and TBS >= 1.310 in AS patients revealed a higher mean body mass index [BMI] (p = 0.010), lower tibia cortical vBMD [Ct.vBMD] (p = 0.007), lower tibia cortical thickness [Ct.Th] : (p = 0.048) in the former group. On logistic regression analysis, BMI (OR = 1.27; 95%IC = 1.08-1.50, p = 0.005), (VF 4.65; 1.13-19.1, p = 0.033) and tibial Ct.vBMD (0.98; 0.97-1.00, p = 0.007) were associated with a lower TBS ( < 1.310). Conclusions: The present study demonstrates that TBS and HR-pQCT imaging are important technologies evaluating bone impairment in AS patients. Moreover, in these patients vertebral fractures were associated with lower TBS.

Palavras-chave

Ankylosing spondylitis, Trabecular bone score, HR-pQCT, DXA, Bone density, Vertebral fractures

URI

https://observatorio.fm.usp.br/handle/OPI/31627

Referências

Alvarenga JC, 2017, OSTEOPOROSIS INT, V28, P1335, DOI 10.1007/s00198-016-3876-0
Boutroy S, 2005, J CLIN ENDOCR METAB, V90, P6508, DOI 10.1210/jc.2005-1258
Briot K, 2015, RMD OPEN, V1, DOI 10.1136/rmdopen-2014-000014
Cao JJ, 2011, J ORTHOP SURG RES, V6, DOI 10.1186/1749-799X-6-30
Capaci K, 2003, YONSEI MED J, V44, P379, DOI 10.3349/ymj.2003.44.3.379
Carter Shea, 2011, Curr Osteoporos Rep, V9, P112, DOI 10.1007/s11914-011-0058-z
Creemers MCW, 2005, ANN RHEUM DIS, V64, P127, DOI 10.1136/ard.2004.020503
Domiciano DS, 2013, ARTHRIT CARE RES, V65, P809, DOI 10.1002/acr.21905
Feldtkeller E, 2006, RHEUMATOL INT, V26, P234, DOI 10.1007/s00296-004-0556-8
Fuller H, 2015, REV BRAS REUMATOL, V55, P352, DOI [10.1016/j.rbr.2014.07.010, 10.1016/j.rbre.2014.07.010]
GENANT HK, 1993, J BONE MINER RES, V8, P1137, DOI 10.1002/jbmr.5650080915
Geusens P, 2001, J RHEUMATOL, V28, P1856
Geusens P, 2014, NAT REV RHEUMATOL, V10, P304, DOI 10.1038/nrrheum.2014.23
Ghozani I, 2009, BONE, V44, P772, DOI 10.1016/j.bone.2008.12.028
Gilgil E, 2005, J RHEUMATOL, V32, P292
Grazio S, 2012, RHEUMATOL INT, V32, P2801, DOI 10.1007/s00296-011-2066-9
Haroon NN, 2015, ARTHRITIS RES THER, V17, DOI 10.1186/s13075-015-0873-1
Klingberg E, 2013, ARTHRITIS RES THER, V15, DOI 10.1186/ar4368
Klingberg E, 2012, J RHEUMATOL, V39, P1987, DOI 10.3899/jrheum.120316
Kolta S, 2014, OSTEOPOROSIS INT, V25, P1759, DOI 10.1007/s00198-014-2685-6
Kolta S., 2018, J CLIN DENSITOM, P30024
Lee YSL, 1997, AM J MED, V103, P233, DOI 10.1016/S0002-9343(97)00143-5
Magrey MN, 2016, SEMIN ARTHRITIS RHEU, V46, P88, DOI 10.1016/j.semarthrit.2016.03.003
McCloskey EV, 2016, J BONE MINER RES, V31, P940, DOI 10.1002/jbmr.2734
Muschitz C, 2015, BONE, V79, P259, DOI 10.1016/j.bone.2015.06.007
Neumann A, 2018, ARTHRITIS RES THER, V20, DOI 10.1186/s13075-018-1620-1
Padlina I, 2017, OSTEOPOROSIS INT, V28, P909, DOI 10.1007/s00198-016-3829-7
Pasoto SG, 2016, RHEUMATOLOGY, V55, P2200, DOI 10.1093/rheumatology/kew332
Paupitz J. A., 2006, OSTEOPOROSIS INT, V27, P1839
Sieper J, 2002, ANN RHEUM DIS, V61, P8
Sieper J., 2009, ANN RHEUM DIS S2, V68
Singh HJ, 2013, J CLIN DIAGN RES, V7, P2832, DOI 10.7860/JCDR/2013/6779.3770
VANDERLINDEN S, 1984, ARTHRITIS RHEUM, V27, P361
Wildberger L, 2017, JOINT BONE SPINE, V84, P463, DOI 10.1016/j.jbspin.2016.05.015

Coleções

Artigos e Materiais de Revistas Científicas - FM/MCM
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - LIM/17

Página do item completo