ABSTRACT
PURPOSE: The aim of the study was the composite estimation of bone tissue metabolism in ankylosing spondylitis (AS) after having taken into account such factors as a high risk of incidence of osteoporosis in patients with AS and potential danger of permanent immobility. MATERIAL AND METHODS: Sixty-six patients with established diagnosis of AS and 63 healthy individuals in the control group were included into the study. To measure bone mineral density (BMD) the dual energy X-ray absorptiometry (DEXA) method was used. Additionally, biochemical markers of osteoporosis such as bone fraction of an alkaline phosphatase (BALP), osteocalcin (BGP) and deoxypyridinoline (Dpd) as well as many inflammatory markers of disease activity have been determined. RESULTS: In our study with AS had significantly diminished bone mineral density, as compared with health controls. The presence of osteopenia/osteoporosis was associated with longer duration of the disease and with higher age. In the overall group of AS patients bone degradation marker, Dpd, correlated with serum concentration of interleukin 6 (IL-6), tumor necrosis factor alpha (TNF-alpha) and C-reactive protein (CRP), and inversely with BMD measured in the forearm. However, no direct association could be revealed between lower bone density and markers of inflammation or inflammatory cytokines, except of IL-6 witch was significantly higher in AS patients with osteoporosis/osteopenia than those without. CONCLUSIONS: Our results indicate that disease duration and higher age are risk factors for osteoporosis in patients with AS. Inflammation might contribute to the accelerated bone loss in AS through stimulation of bone degradation.
Subject(s)
Bone and Bones/metabolism , Spondylitis, Ankylosing/diagnostic imaging , Spondylitis, Ankylosing/metabolism , Adult , Aged , Bone Density , C-Reactive Protein/metabolism , Cytokines/metabolism , Densitometry/methods , Humans , Inflammation , Interleukin-6/metabolism , Male , Middle Aged , Osteoporosis/metabolism , Radiography , Risk , Tumor Necrosis Factor-alpha/metabolismABSTRACT
The aim of this work was to compare the outcome of the questionnaire survey of low back pain with data on related sickness absenteeism. The questionnaire was responded by 585 (88.8%) employees. Of these number 288 (49.2%) respondents complained of low back pain. Sick leaves were given to 48 (16.7%) persons who had reported low back pains in the questionnaire and to 25 (8.4%) employees of 297 who had not reported the pain and also to 4 (5.4%) persons of 57 who had not responded to the questionnaire. Among those who had not complained of low back pain and were given sick leaves, mostly short ones, there were mainly men and blue collar workers. On the basis of our survey it seems that the analysis of sickness absenteeism due to low back pain does not completely reflect the prevalence of this disease, and that epidemiological studies of the prevalence should also take into consideration relevant sickness absenteeism.
