OSTEOPOROSIS IN PATIENTS WITH ANKYLOSING SPONDYLITIS

Abstract

Currently, rheumatologists consider osteoporosis as a complication of ankylosing spondylitis, however, in recent years, it is discussed as a comorbidity but not a complication. Disturbances in bone tissue metabolism provoked by ankylosing spondylitis-related inflammation increase the risk of osteoporosis and suggest osteoporosis as a manifestation of ankylosing spondylitis. Further, patients with ankylosing spondylitis are frequently diagnosed with a reduction of bone mineral density, the extent of which is determined by gender, age, type and duration of ankylosing spondylitis, severity of the inflammation, vitamin D deficiency, and extraskeletal calcification. Inflammation defined by excessive levels of pro-inflammatory cytokines plays a leading role in the development of osteoporosis. Another reason of bone loss in patients with ankylosing spondylitis is dysregulated balance in RANK/RANKL/OPG pathway. A combination of sarcopenia and osteopenia/osteoporosis (sarco-osteopenia/sarco-osteoporosis) results in a significant increase in the risk of low-energy fractures affecting quality of life, morbidity, and mortality in this patient category. Therefore, an active screening for osteoporosis/sarco-osteopenia/sarco-osteoporosis followed by the respective secondary prevention and treatment is of particular importance

Keywords

• анкилозирующий спондилит
• остеопороз
• ankylosing spondylitis
• osteoporosis