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Evaluation of bone mineral density in patients of spondyloarthritis in a tertiary care center

Akhil Gupta, Ranjan Bhatnagar, Manaswi Chaubey, Sanjay Yadav, Tamanna Singh, Akhilendra Choudhary.


Background: Spondyloarthritis (SpA) is the disease of young population. Low bone mineral density (BMD) has been well documented in patients of ankylosing spondylitis but less studied in patients of SpA which includes reactive, enteropathic, psoriatic, and undifferentiated SpA.

Aims and Objectives: This study was done to evaluate the BMD in patients of SpA and its correlation with disease activity and inflammatory markers.

Materials and Methods: This was a cross-sectional case–control study. Thirty-five newly diagnosed SpA patients and equal number of age and sex matched healthy controls were included. A detailed history, examination, and dual-energy X-ray absorptiometry scan of lumber spine and femur neck was done.

Results: The mean age in our cases and control groups were 26.60 ± 6.63 years and 27.63 ± 4.10 years, respectively. The duration of illness was 2.3 ± 1.3 years. 71.4% patients were male and 28.6% were female. The mean C-reactive protein (CRP) values at the time of diagnosis was 7.56 ± 3.4 mg/L. The mean bath ankylosing spondylitis disease activity index (BASDAI) values in patients were 3.17 ± 2.9. BMD correlated with baseline BASDAI and male sex (P < 0.005) among cases and controls. However, we found no relationship between reduced BMD with the pattern of joint involvement, HLA B27 positivity, CRP levels, and duration of onset of symptoms.

Conclusion: The result of this study shows that patients of SpA with high BASDAI score at a very early age are predisposed to low BMD.

Key words: Spondyloarthritis; Bone Mineral Density; DEXA Scan; C-reactive Protein; Osteopenia; Osteoporosis

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