Abstract
Few studies on the benign joint hypermobility syndrome suggest a tendency toward osteopenia, but there are conflicting results. We assessed bone mineral density in pre-menopausal women with hypermobility. Twenty-five consecutive Caucasian women diagnosed with benign hypermobility syndrome by Beighton score and 23 age- and sex-matched controls were included in the study. Age, menarch age, number of pregnancies, duration of lactation, physical activity and calcium intake were questioned according to European Vertebral Osteoporosis Study Group (EVOS) form. All subjects were pre-menopausal and none of them were on treatment with any drugs effecting bone metabolism or had any other systemic disease. No statistically significant difference was found for body mass index, menarch age, number of pregnancies, duration of lactation, calcium intake, calcium score and physical activity score between the two groups. Total femoral and trochanteric bone mineral density and t and z scores were significantly lower in hypermobile patients compared to the control group. Ward’s triangle and femoral neck z scores were also found to be significantly low in hypermobile patients (p<0.05). Significant negative correlations were found between the Beighton scores and trochanteric BMD, t and z scores (r=−0.29, r=−0.30, and r=−0.32) in hypermobility patients. Low bone mass was more frequently found among subjects with hypermobility (p=0.03). Hypermobility was found to increase the risk for low bone mass by 1.8 times (95% confidence interval 1.01–3.38). Our study suggests that pre-menopausal women with joint hypermobility have lower bone mineral density when compared to the controls and hypermobility increases the risk for low bone mass.
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References
Kirk JA, Ansell BM, Bywaters EG (1967) The hypermobility syndrome. Musculoskeletal complaints associated with generalized joint hypermobility. Ann Rheum Dis 26:419–425
Grahme R (1990) The hypermobility syndrome. Ann Rheum Dis 49:190–200
Wordsworth P, Ogilvie D, Smith R, Skyes B (1987) Joint hypermobility with particular reference to racial variation and inherited connective tissue disorders. Br J Rheumatol 26:9–12
Hazleman B (1998) Soft tissue rheumatism. In: Maddison PJ, Isenberg DA, Woo P, Glass NG (eds) Oxford textbook of rheumatology. Oxford University, Oxford, New York, pp 1489–1514
Harinstein D, Buckingham EB, Braun T, Oral K, Baumon DH, Killian PJ, Bidula LP (1988) Systemic joint laxity is associated with temporomandibular joint dysfunction. Arthritis Rheum 31:1259–1264
Rawi ZA, Nessan AH (1997) Joint hypermobility in patients with chondromalacia patella. Br J Rheumatol 36:1324–1327
Hudson N, Starr MR, Esdaile JM, Fitzcharles MA (1995) Diagnostic associations with hypermobility in rheumatology patients. Br J Rheumatol 34:1157–1161
Bridges AJ, Smith E, Reid J (1992) Joint hypermobility in adults referred to rheumatology clinics. Ann Rheum Dis 51:793–796
Russek L (1999) Hypermobility syndrome. Phys Ther 79:591–599
Marini RC (1998). Heritable collagen disorders. In: Klieppel JH, Dieppe PA (eds) Rheumatology. Mosby, London, pp 8.50.1–8.50.8
Hakim A (2003) Joint hypermobility. Best Pract Res Clin Rheumatol 17:989–1004
Dolan AL, Arden NK, Grahme R, Spector TD (1998) Assessment of bone in Ehler Danlos Syndrome by ultrasound and densitometry. Ann Rheum Dis 57:630–633
Carter N, Duncan E, Woodsworth P (2000) Bone mineral density in adults with Marfan Syndrome. Rheumatology 39:307–309
Mishra MB, Ryan R, Atkinson P, Taylor H, Bell J, Calver D, Fogelman I, Child A, Jackson G, Chambers JB, Grahme R (1996) Extra-articular features of benign joint hypermobility syndrome. Br J Rheumatol 35:861–866
Nijs J, Van Essche E, De Munck M, Dequeker J (2000) Ultrasonographic, axial and peripheral measurements in female patients with benign hypermobility syndrome. Calcif Tissue Int 67:37–40
Dolan L, Hart D, Doyle DV, Grahme R, Spector TD (2003) The relationship of joint hypermobility, bone mineral density, and osteoarthritis in general population: the Chingford study. J Rheumatol 30:799–803
Beighton P, Solomon L, Soscolne C (1973) Articular mobility in an African population. Ann Rheum Dis 32:413–418
O’Neil TW, Cooper C, Cannota JB, Daiz LJB, Hoszowski K, Johnell O, Lorenc RS, Nilsson B, Raspe H, Stewart O (1994) Reproducibility of a questionnaire on risk factors for osteoporosis in a multicentre prevelance survey: the European Vertebral Osteoporosis Study. Int J Epidemiol 23:559–565
Dequeker J, Boonen S (1998) Extraskeletal risk and protective factors for fractures. In: Geusens P (ed) Osteoporosis in clinical practice. A practical guide for diagnosis and treatment. Springer, Berlin Heidelberg New York, pp 53–58
Seckin U, Tur BS, Yýlmaz O, Yagci I, Bodur H, Arasil T (2005) The prevalence of joint hypermobility among high school students. Rheumatol Int 25:260–263
Engelbert RH, Bank RA, Sakkers RJ, Helders PJ, Beemer FA (2003) Pediatric generalized joint hypermobility with and without musculoskeletal complaints: a localized or systemic disorder. Pediatrics 111:248–254
Letocha AD, Cintas HL, Troendle JF, Reynolds JC, Cann CE, Chernoff EJ, Hill SC, Gerber LH, Marini JC (2005) Controlled trail of pamidronate in children with types III and IV osteogenesis imperfecta confirms vertebral gains but not short term functional improvement. J Bone Miner Res 20:977–986
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Gulbahar, S., Şahin, E., Baydar, M. et al. Hypermobility syndrome increases the risk for low bone mass. Clin Rheumatol 25, 511–514 (2006). https://doi.org/10.1007/s10067-005-0103-3
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DOI: https://doi.org/10.1007/s10067-005-0103-3