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Severity of sacroiliitis, ESR tied to low trabecular bone score in men with ankylosing spondylitis

07 Mar 2018

The use of trabecular bone score (TBS) may be helpful in evaluating osteoporosis in ankylosing spondylitis (AS), as it is associated with the erythrocyte sedimentation rate (ESR) and severity of sacroiliitis in young male patients with AS, suggests a recent study.

The TBS had a mean of 1.38. It was positively associated with bone mineral density (BMD) at the lumbar spine, femoral neck and total hip, and negatively associated with the Stoke Ankylosing Spondylitis Spine Score (SASSS).

Patients with spinal structural damage showed a significant reduction in TBS values (p=0.001). In univariate analysis, TBS correlated with disease duration, ESR, sacroiliitis grade and SASSS, while multivariate analysis identified ESR (p=0.006) and sacroiliitis grade (p<0.001) as independently correlated with TBS.

Morphometric vertebral fractures were present in 10 patients. Those with vertebral fractures had lower mean TBS than age-matched patients without fractures (p=0.028). Lower TBS was found to be a predictor of vertebral fractures (area under curve, 0.733; cutoff, 1.311).

The authors enrolled 100 patients (aged <50 years; 100 percent male) who fulfilled the modified New York criteria for the classification of AS to examine factors related to a low TBS and the association between TBS and vertebral fractures in AS patients.

Using dual-energy X-ray absorptiometry, the TBS and BMD were calculated. In addition, the authors assessed clinical variables, inflammatory markers and the presence of vertebral fractures. They used the modified New York criteria and the SASSS to measure sacroiliitis grade and spinal structural damage.

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