title: Clinical Risk Factors for the Presence and Development of Vertebral Fractures in Patients With Ankylosing Spondylitis.
abstract: To investigate the prevalence and incidence of radiographic vertebral fractures and the association with patient characteristics, clinical assessments, and medication use in a large prospective cohort of patients with ankylosing spondylitis (AS) in daily clinical practice.
  
  
  
  Consecutive AS patients from the Groningen Leeuwarden AS (GLAS) cohort with baseline and 2-year lateral radiographs of the thoracic and lumbar spine were included. Radiographs were scored for vertebral fractures by 2 readers according to the method of Genant et al. Differences in baseline characteristics between patients with and without radiographic vertebral fractures were explored.
  
  
  
  Of 292 included AS patients, 59 (20%) had radiographic vertebral fractures at baseline, 15 (6%) developed new fractures, and 7 (2%) showed an increase in the severity of existing fractures during 2 years of follow-up. Most fractures were mild and located in the midthoracic and thoracolumbar region of the spine. The presence of vertebral fractures was significantly associated with older age, higher body mass index, longer smoking duration, larger occiput-to-wall distance, more spinal radiographic damage, and lower hip bone mineral density (BMD). The development of new or progressive vertebral fractures was also associated with older age and low BMD. Patients using nonsteroidal antiinflammatory drugs (NSAIDs) at baseline showed less prevalent and incident vertebral fractures.
  
  
  
  In this large AS cohort in daily clinical practice, radiographic vertebral fractures were frequently present in AS, especially in older patients with more advanced disease, low hip BMD, and a less healthy lifestyle. Interestingly, NSAID use was associated with a reduced vertebral fractures risk.
authors.affiliation: University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Fiona
authors.initials: F
authors.lastname: Maas
authors.affiliation: University of Groningen, University Medical Center Groningen, Groningen, and Medical Center Leeuwarden, Leeuwarden, The Netherlands.
authors.forename: Anneke
authors.initials: A
authors.lastname: Spoorenberg
authors.affiliation: University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Boukje P G
authors.initials: BPG
authors.lastname: van der Slik
authors.affiliation: University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Eveline
authors.initials: E
authors.lastname: van der Veer
authors.affiliation: University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Brouwer
authors.affiliation: University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Hendrika
authors.initials: H
authors.lastname: Bootsma
authors.affiliation: Medical Center Leeuwarden, Leeuwarden, The Netherlands.
authors.forename: Reinhard
authors.initials: R
authors.lastname: Bos
authors.affiliation: Medical Center Leeuwarden, Leeuwarden, The Netherlands.
authors.forename: Freke R
authors.initials: FR
authors.lastname: Wink
authors.affiliation: University of Groningen, University Medical Center Groningen, Groningen, and Medical Center Leeuwarden, Leeuwarden, The Netherlands.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Arends
mesh_terms: D000328:Adult; D000367:Age Factors; D015992:Body Mass Index; D015519:Bone Density; D005260:Female; D006801:Humans; D015994:Incidence; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D011859:Radiography; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology*; D013167:Spondylitis, Ankylosing / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries*