| Abstract [eng] |
The aim of this work was to determine consistent patterns of BMD changes at the lumbar spine and the upper part of the left and right femur in patients with SpA (AS, ReA, PsA, EnA) and to assess relation between changes of bone mass and specific factors of the disease (duration of the disease, physical disability and immobility, activity of the disease, medications in use). It was established that in patients with SpA BMD is the same as in patients with rheumatoid arthritis and is significantly lower in comparison with BMD of healthy subjects measured at the lumbar spine and upper part of the left and right femur. Similar BMD changes at the lumbar spine and upper part of the left and right femur are characteristic of SpA patients with various diseases belonging to SpA group and do not depend on the predominant type of joint lesion. The duration of the disease reflects changes in BMD better when it is calculated not from the time of the establishment of clinical diagnosis, but from the time of onset of first clinical symptoms. BMD decrease at the upper part of the left and right femur and increase at the spine with the increase of the duration of disease. Moderate and high activity of the disease established by rheumatologist contribute to BMD loss at the lumbar spine and upper parts of the both femurs. BMD reduction at the lumbar spine and the upper part of the left and right femur is associated with the decrease of mmobility of SpA patients. Intermalleolar distance is the most precise indicant of this relation: the lowest BMD at the upper part of the left and right femur is measured when reduction of spine movement is defined as severe. Significant negative association between cumulative dose of glucocorticoids and BMD changes at the lumbar spine and upper part of the left and right femur were observed. |
