engleski

Trabecular bone score in addition to bone mineral density in female patients with psoriatic arthritis.

Objectives: In patients with psoriatic arthritis (PsA) the studies evaluating BMD using DXA provide inconsistent and conflicting results, and there are a limited number of studies that evaluated bone microarchitecture. The aims of the study were to assess the bone microarchitecture by trabecular bone score (TBS) using DXA in addition to BMD in PsA patients and controls and to investigate the determinants of a low TBS among patients. Methods: The study included 60 female PsA patients aged 61.85±8.43 (mean, SD) y and 107 age-matched female controls. Spine and hip BMD were assessed by DXA. TBS was calculated from the anteroposterior image of the spine BMD. Results: The prevalence of osteoporosis (T-score ≤ -2.5) in PsA patients was similar to controls (23.3% and 21.5%, respectively). However, a significantly higher proportion of controls had a T-score between -2.4 and -1.0, compared to patients (61.7% vs. 43.3%, p=0.032). There were no significant between-group differences in TBS and BMD at the lumbar spine, while significantly higher BMD at the femoral neck was detected in patients (p=0.017). Patients had significantly higher weight (mean 77.13±13.45 kg) and higher BMI (28.45±4.99 kg/m2) compared to controls, all p<0.05. According to TBS results (1.36±0.09) the patients with a TBS in the lowest tertile (TBS ≤ 1.33, n=20) were compared to patients with a TBS value in the 2 upper tertiles (TBS > 1.34, n=40). In univariate analysis low TBS showed trends of association toward higher BMI, to higher prevalence of low T-score (< -1.0) and to a lower lumbar spine BMD, however the results did not reach significance. No association was observed between low TBS and age, duration of the disease, previous non-traumatic fractures, menopause duration, or use of GCs. Conclusions: Our results show no significant differences in the prevalence of osteoporosis and in TBS values between PsA patients and controls. Surprisingly, we observed significantly higher femoral neck BMD in patients compared to controls, which might be explained by significantly higher weight and BMI among patients. We found no predictors of low TBS related to parameters of the disease.

osteoporosis ; TBS ; psoriatic arthritis ;

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