The relation between osteoporosis and vitamin D levels and disease activity in ankylosing spondylitis.
In this study, the relation between osteoporosis and vitamin D and the disease activity in patients with ankylosing spondylitis (AS) was investigated. A hundred patients with AS and 58 healthy individuals were included in the study. In addition to the routine blood and urine tests, serum 25-(OH)D3, parathormone (PTH), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), total calcium, ionized calcium, and phosphorous levels of all participants were also measured. Bone mineral density (BMD) measurements were performed at the anterior-posterior and lateral lumbar and femur regions. Anterior-posterior and lateral thoracic and lumbosacral radiography was performed on all participants. The disease activity was evaluated by Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), functional status by Bath Ankylosing Spondylitis Functional Index (BASFI), and mobility by Bath Ankylosing Spondylitis Metrology Index (BASMI). In the patient group, BMD values obtained from the lateral lumbar and femur regions and serum vitamin D levels were lower than the control group. A negative relation was determined between the lateral lumbar BMD values and ESR, CRP, and BASDAI scores of patients with AS. The ESR, CRP levels, and BASMI scores of the AS patients with osteoporosis were significantly higher, when compared to patients without osteoporosis. The negative correlation between serum 25-(OH)D3 level and ESR, CRP levels did not reach a statistically significant level in patients with AS; the positive correlation between PTH levels and ESR, and the negative correlation between CRP and BASDAI also did not reach a statistically significant level. Vitamin D deficiency in AS may indirectly lead to osteoporosis by causing an increase in the inflammatory activity. The present authors believe that it would be beneficial to monitorize vitamin D levels together with BMD measurements in order to determine the patients under osteoporosis risk.
Mermerci Başkan
Bedriye
B
Department of Physical Therapy, Ankara Numune Education and Research Hospital, 86 Sokak, 9/16 Emek, Ankara, Turkey. bmbaskan@yahoo.com.tr
Pekin Doğan
Yasemin
Y
Sivas
Filiz
F
Bodur
Hatice
H
Ozoran
Kürşat
K
D000328:Adult; D015415:Biomarkers / Q000032:analysis; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000032:analysis / Q000378:metabolism; D002118:Calcium / Q000032:analysis / Q000097:blood; D015897:Comorbidity; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000453:epidemiology / Q000503:physiopathology; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000097:blood* / Q000453:epidemiology* / Q000503:physiopathology; D010281:Parathyroid Hormone / Q000032:analysis / Q000097:blood; D010758:Phosphorus / Q000032:analysis / Q000097:blood; D011237:Predictive Value of Tests; D011859:Radiography; D012307:Risk Factors; D012720:Severity of Illness Index; D013131:Spine / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000473:pathology; D013167:Spondylitis, Ankylosing / Q000097:blood* / Q000453:epidemiology* / Q000503:physiopathology; D014807:Vitamin D / Q000032:analysis / Q000097:blood*
D015415:Biomarkers; D010281:Parathyroid Hormone; D014807:Vitamin D; D010758:Phosphorus; D002097:C-Reactive Protein; D002118:Calcium
J Rheumatol. 1999 Oct;26(10):2205-9
10529141
Rheumatol Int. 2005 Dec;26(2):115-20
15538574
Lymphokine Cytokine Res. 1991 Apr;10(1-2):15-21
1873357
Bone. 1995 Aug;17(2 Suppl):63S-67S
8579900
BMJ. 1993 Jul 17;307(6897):172-3
8343746
Clin Orthop Relat Res. 1971 Jan;74:59-64
5540407
J Rheumatol. 1998 May;25(5):929-35
9598894
J Rheumatol. 1986 Oct;13(5):932-5
3820204
J Rheumatol. 1994 Dec;21(12):2286-91
7699630
Osteoporos Int. 2005 Dec;16(12):1999-2004
16172800
Ann Rheum Dis. 1994 Feb;53(2):117-21
8129456
J Rheumatol. 1994 Sep;21(9):1694-8
7799351
Osteoporos Int. 1993 May;3(3):113-9
8481586
Clin Rheumatol. 1999;18(5):364-8
10524549
FASEB J. 2001 Dec;15(14):2579-85
11726533
J Rheumatol. 1994 Oct;21(10):1877-82
7837154
Joint Bone Spine. 2004 Jul;71(4):291-5
15288853
Clin Rheumatol. 2005 Feb;24(1):41-7
15365877
J Investig Dermatol Symp Proc. 1996 Apr;1(1):68-71
9627696
J Rheumatol. 2004 Nov;31(11):2236-41
15517638
J Rheumatol. 2002 Jul;29(7):1511-9
12136913
J Bone Joint Surg Br. 1994 Jul;76(4):660-5
8027159
J Bone Miner Res. 1997 Nov;12(11):1844-50
9383689
J Rheumatol. 1994 Dec;21(12):2281-5
7699629
Arthritis Rheum. 1984 Apr;27(4):361-8
6231933
Ann N Y Acad Sci. 1990;587:371-5
1972874
J Rheumatol Suppl. 2005 Sep;76:11-20
16142846
J Int Med Res. 1989 Jul-Aug;17(4):395-400
2792558
Arthritis Rheum. 1992 Sep;35(9):1062-7
1418022
Endocrinology. 1994 Nov;135(5):2006-11
7956923
Br J Rheumatol. 1994 Oct;33(10):927-31
7921752
Osteoporos Int. 2001 Dec;12(12):1031-5
11846329
Endocr Rev. 1995 Apr;16(2):200-57
7781594
J Rheumatol. 2005 Feb;32(2):292-4
15693090
Bone. 1998 May;22(5):509-14
9600785
Steroids. 1987 Jan-Mar;49(1-3):55-72
3331847
Lancet. 1989 Dec 23-30;2(8678-8679):1483-5
2574769
Arthritis Rheum. 1999 Nov;42(11):2319-24
10555026
BMJ. 1990 Mar 3;300(6724):563-5
2108749