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Cortical bone loss is an early feature of nonradiographic axial spondyloarthritis
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Cortical bone loss is an early feature of nonradiographic axial spondyloarthritis
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Journal Article
Cortical bone loss is an early feature of nonradiographic axial spondyloarthritis
2018
Overview
Background
In 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.
Methods
Patients 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.
Results
Patients 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.
Conclusions
Bone 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.
Publisher
BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
Subject
