Slik, B. van der (Boukje) (2015) Clinical assessments, bone formation and bone loss in patients with ankylosing spondylitis at baseline and after 2 years follow-up: male versus female. thesis, Medicine.
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Abstract
Introduction: Ankylosing spondylitis (AS) is an autoinflammatory rheumatic disease characterized by bone formation and bone loss in mainly the SI-joints and spine. The clinical presentation may differ between genders. Our aim was to investigate differences in clinical assessments (including disease activity), radiographic damage (mSASSS) and bone loss (vertebral fractures (VF) and bone mineral density (BMD)) between genders at baseline and after 2 years follow-up. Methods: AS patients of the Groningen Leeuwarden AS (GLAS) cohort were included based on the presence of a baseline and 2-year visit. Clinical and radiological outcomes were assessed. Radiographs, blinded for patient characteristics, were scored by 2 independent readers using the modified Stoke AS Spinal Score (mSASSS) and the Genant method (VF). Results: 348 patients were included (68% male). Female patients scored significantly higher on the subjective and combined subjective-objective measures for disease activity. The change in disease activity over 2 years was similar between genders. At baseline, male patients had significantly more radiographic damage (median mSASSS 6 versus 2) and a significantly higher median radiographic progression after 2 years than female patients. In 53 patients (20%), ≥1 vertebral fracture was observed at baseline and after 2 years, 12 patients (5%) developed a new vertebral fracture, with comparable results in males and females. At baseline, the BMD of the lumbar spine was significantly lower and increased significantly more during 2 years of follow-up in men. Conclusion: Female patients experienced a higher disease activity, while male patients had significantly more radiographic damage and a lower BMD. The change in clinical measures of disease activity was comparable between genders, but males showed more radiographic progression and a higher increase in BMD over 2 years.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Faculty supervisor: and Spoorenberg, Ms. J.P.L. MD/PhD and Second Supervisor: and Maas, Ms F. and University Medical Centre Groningen and Department of Rheumatology and Clinical Immunology |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:41 |
| Last Modified: | 25 Jun 2020 10:41 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/273 |
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