Abstract | OBJECTIVES: To assess bone mineral density (BMD) at lumbar spine and hip in a large cohort of patients with early inflammatory back pain ( IBP) suggestive of axial spondyloarthritis (SpA), and to assess systemic and bone inflammation (according to MRI) as risk factors of low BMD. PATIENTS AND METHODS: 332 (52.4% male) patients with IBP suggestive of axial SpA defined by Calin or Berlin criteria were recruited; they had lumbar spine and hip BMD and body composition measurements. Low BMD was defined by Z≤-2 (at least one site). Clinical, biological (erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP)) and imaging (x-rays, spine and sacroiliac joint MRI) parameters were compared in patients with and without low BMD (Z≤-2). Significant parameters in univariate analysis were tested in multivariate models. RESULTS: Patients (mean age 33.8 years) had a short duration of axial symptoms (mean 1.6 years); 71.4% fulfilled the Assessment of Spondyloarthritis International Society criteria for axial SpA and HLA-B27 was present in 62.1%. 43 (13.0%) had low BMD (88% male). Multivariate logistic regression showed that parameters significantly associated with low BMD (any site) were the presence of bone marrow oedema (inflammatory lesions) on MRI (OR 4.63, p=0.001), either ESR or CRP (OR 2.60, p=0.037) and male gender (OR 9.60, p=0.0004). CONCLUSIONS: This study conducted in a large cohort of young adults with early IBP suggestive of SpA shows that 13.0% of patients have a low BMD and that the main risk factor associated with low BMD was inflammation on MRI.
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Authors | Karine Briot, Anne Durnez, Simon Paternotte, Corinne Miceli-Richard, Maxime Dougados, Christian Roux |
Journal | Annals of the rheumatic diseases
(Ann Rheum Dis)
Vol. 72
Issue 12
Pg. 1914-9
(Dec 2013)
ISSN: 1468-2060 [Electronic] England |
PMID | 23161904
(Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
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Chemical References |
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Topics |
- Absorptiometry, Photon
(methods)
- Adolescent
- Adult
- Back Pain
(epidemiology, etiology, physiopathology)
- Blood Sedimentation
- Bone Density
(physiology)
- Bone Diseases
(complications, diagnosis, epidemiology, physiopathology)
- C-Reactive Protein
(metabolism)
- Cohort Studies
- Edema
(complications, diagnosis, epidemiology, physiopathology)
- Female
- France
(epidemiology)
- Hip Joint
(physiopathology)
- Humans
- Lumbar Vertebrae
(physiopathology)
- Magnetic Resonance Imaging
- Male
- Middle Aged
- Osteoporosis
(diagnosis, epidemiology, etiology, physiopathology)
- Risk Factors
- Spondylarthritis
(complications, epidemiology, physiopathology)
- Young Adult
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