Relationship Between Disease Activity And Bone Metabolism And Bone Mass In Axial Spondyloarthritis

Objective: To investigate the relationship between axial spondyloarthrits(ax-Sp A)disease activity and bone metabolism and bone mass.Methods: 1.A total of 55 ax-Sp A patients admitted to the Department of Rheumatology and Immunology of Second Affiliated Hospital of Guangxi Medical University from February 2019 to February 2021 were collected according to the inclusion criteria,chemiluminescence method for determination of patients with type I collagen amino terminal extension of the peptide(t-P1NP),beta collagen degradation products(β-CTX),osteocalcin in the n-terminal molecular fragment(N-MID),dual-energy X-ray absorptiometry method patients’ bone mineral density(BMD)in lumbar spine(L1-L4)and femoral(for all);2.Patients were divided into disease activity group and non-disease activity group according to BASDAI score > 4 or ASDAS-ESR score ≥1.3 or ASDAS-CRP score ≥1.3;3.According to bone mineral density T <-1.0 or Z ≤-2.0,the enrolled patients were divided into abnormal bone mass group and normal bone mass group;4.The correlation between disease activity and bone metabolism and bone mineral density was analyzed by Pearson or Spearman.5.Logistic regression was used to analyze the risk factors of abnormal BMD in ax-Sp A patients.normal value(9.06-76.24)ng/m L,N-MID(29.27±15.17)ng/m L、normal value(14.00-46.00)ng/m L,β-CTX(0.721±0.339)ng/m L 、 normal value(0.000-0.704)ng/m L;2.Bone mineral density measurements showed normal bone mass in 33 patients(60%),decreased bone mass in 17 patients(31%),and osteoporosis in 5 patients(9%);3.The mean T and Z values of lumbar vertebral bone density in the disease activity group and the non-disease activity group were respectively:(-1.64±1.43)VS(0.05±1.41),P < 0.01 and(-0.62±1.44)VS(0.66±1.32),P < 0.05.The differences in femoral bone mineral density and t-P1 NP,N-MID and β-CTX between the two groups were statistically insignificant,P > 0.05;4.The mean values of ESR,CRP,ASDAS-ESR and ASDAS-CRP in abnormal bone mass group and normal bone mass group were:(41.29±24.88)VS(26.35±20.47)、(35.91±41.54)VS(15.24±19.42)、(3.13±0.94)VS(2.51±1.07)、(3.27±1.05)VS(2.55±1.06),the difference was statistically significant(P < 0.05).5.ESR,CRP,BASDAI score,ASDAS-CRP score,ASDAS-ESR score had no significant correlation with t-P1 NP,N-MID,β-CTX,P > 0.05;6.ESR was negatively correlated with T and Z values of lumbar spine bone density and T values of femur bone density(P <0.05).CRP was negatively correlated with T and Z values of bone mineral density of lumbar spine and femur(P < 0.05).ASDAS-ESR score was correlated with T values of lumbar spine and femur bone mineral density(P <0.05).ASDAS-CRP score was negatively correlated with T value of lumbar bone density,T value and Z value of femur bone density(P < 0.05);7.Logistic regression analysis was performed with gender,age,BMI,disease duration,HLA-B27,ESR,CRP,serum calcium,serum uric acid,BASDAI,ASDAS-CRP,and ASDAS-ESR as independent variables.The results indicated that the higher the ESR,the greater the risk of reduction of lumbar and femoral BMD was,withResults: 1.Bone metabolism markers: t-P1NP(83.90±48.83)ng/m L、OR values of 1.082,1.035,1.040,1.038,respectively,P < 0.05.Conclusions: 1.Disease activity in axial spondyloarthritis promotes bone loss;2.Erythrocyte sedimentation rate is a risk predictor of osteopenia in ax-Sp A patients.