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Osteoporosis in psoriatic arthritis: Is there any?

Osteoporose bei Psoriasis-Arthritis: gibt es sie?

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Zusammenfassung

ZIELE: Obwohl es als ein Merkmal entzündlich-rheumatischer Erkrankungen angesehen wird, gibt es viel Kontroverse über die niedrige Knochenmasse bei Patienten mit psoriatischer Arthritis. Das Ziel dieser Querschnittsstudie war es, die Knochenmineraldichte bei Patienten mit psoriatischer Arthritis zu analysieren, sowie ihre mögliche Verbindung mit einigen Ausmaßen der Krankheitsaktivität und funktionaler Kapazität zu untersuchen. PROBANDEN UND METHODEN: Neunundsechzig Patienten, bei denen psoriatische Arthritis festgestellt wurde (Durchschnittsalter 56,20 ± 12,23 Jahre), und die nicht mit gezielten antiosteoporotischen Medikamenten behandelt wurden, wurden aus der klinischen Datenbank ambulanter Patienten angeworben. Die Knochenmineraldichte wurde an der Lendenwirbelsäule und an der linken Hüfte mittels Dualröntgenabsorptiometrie gemessen. Die Ausmaße der Krankheitsaktivität umfassten: Dauer der Morgensteifheit, schmerzende Gelenkschwellung, allgemeine Einschätzung durch den Patienten selbst und durch den Arzt, Manifestation von Daktylitis und/oder Enthesitis, ESR und CRP, und Krankheits-Aktivitäts-Score (DAS 28). Ein Fragebogen zur Beurteilung der Gesundheit (HAQ) wurde verwendet, um den funktionalen Status der Patienten zu beurteilen. ERGEBNISSE: Laut Definition der Weltgesundheitsorganisation wurde bei 7,2 % der Patienten Wirbelsäulenosteoporose, bei 1,4 % der Patienten Osteoporose des Hüftgelenks und bei 2,9 % der Patienten Osteoporose des Schenkelhalses festgestellt. Es gab keine signifikante Verbindung von keinem der Ausmaße der Krankheitsaktivität mit der Knochenmineraldichte an keinem der Messbereiche. Eine höhere HAQ Punktzahl wurde in Verbindung gebracht mit niedrigerer Knochenmineraldichte des Hüftgelenks. SCHLUSSFOLGERUNG: Anhand unserer Stichprobe der Patienten mit Psoriasis-Arthritis haben wir keine erhöhte Prävalenz der Osteoporose gefunden. Es gab keine Verbindung von Knochenmineraldichte mit Hinweisen auf Krankheitsaktivität, während negative Korrelation festgestellt wurde zwischen dem HAQ und der Knochenmineraldichte des Hüftgelenks.

Summary

AIMS: Although considered as a feature of inflammatory rheumatic diseases, there is a lot of controversy around low bone mass in patients with psoriatic arthritis. The aim of this cross-sectional study was to analyze bone mineral density in patients with psoriatic arthritis, as well as to investigate its possible association with some measures of disease activity and functional capacity. SUBJECTS AND METHODS: Sixty-nine patients with established psoriatic arthritis (mean age 56.20 ± 12.23 years) and who have not been treated with specific antiosteoporotic drugs were recruited from the out-patient clinic database. Bone mineral density was measured by dual-energy X-ray absorptiometry at the lumbar spine and at the left hip. Disease activity measures included: duration of morning stiffness, tender and swollen joint count, patient's and physician's global assessment, presence of dactylitis and enthesitis, ESR, CRP and Disease Activity Score 28. Health Assessment Questionnaire was used to assess functional status. RESULTS: According to WHO definition, spinal osteoporosis was found in 7.2% of patients, total hip osteoporosis in 1.4% of patients and femoral neck osteoporosis in 2.9% of patients. There was no significant association of any of the measures of disease activity with BMD at any site. Higher HAQ scores were associated with lower total hip BMD. CONCLUSIONS: In our sample of patients with psoriatic arthritis we did not find increased prevalence of osteoporosis. There was no association of BMD with indices of disease activity, while negative correlation was found between HAQ and total hip BMD.

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Authors and Affiliations

  1. University Department of Rheumatology, Physical and Rehabilitation Medicine, "Sisters of Mercy" University Hospital Centre, Referral Centre for Spondyloarthropathies of the Ministry of Health and Social Welfare Republic of Croatia, Zagreb, Croatia

    Simeon Grazio, Frane Grubišić, Valentina Matijević & Tomislav Nemčić

  2. Institute for Medical Research and Occupational Health, Zagreb, Croatia

    Selma Cvijetić

  3. Department for Physical Medicine, Rehabilitation and Rheumatology, University Hospital Center Split, Split, Croatia

    Tonko Vlak

  4. University Department of Oncology and Nuclear Medicine, "Sisters of Mercy" University Hospital, Zagreb, Croatia

    Marija Punda & Zvonko Kusić

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  1. Simeon Grazio
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  2. Selma Cvijetić
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  3. Tonko Vlak
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  4. Frane Grubišić
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  6. Tomislav Nemčić
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Correspondence to Simeon Grazio.

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Grazio, S., Cvijetić, S., Vlak, T. et al. Osteoporosis in psoriatic arthritis: Is there any?. Wien Klin Wochenschr 123, 743–750 (2011). https://doi.org/10.1007/s00508-011-0095-8

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