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Gamez-Nava JI, de la Cerda-Trujillo LF, Vazquez-Villegas ML, Cons-Molina F, Alcaraz-Lopez MF, Zavaleta-Muñiz SA, Rocha-Muñoz AD, Martinez-Garcia EA, Corona-Sanchez EG, Salazar-Paramo M, Fajardo-Robledo NS, Olivas-Flores EM, Cardona-Muñoz EG, Gonzalez-Lopez L. Association between bone turnover markers, clinical variables, spinal syndesmophytes and bone mineral density in Mexican patients with ankylosing spondylitis. Scand J Rheumatol 2016; 45:480-490. [PMID: 27218482 DOI: 10.3109/03009742.2016.1152399] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES To compare bone turnover marker (BTM) levels and bone mineral density (BMD) between patients with ankylosing spondylitis (AS) and healthy controls (HC) and to evaluate, in AS, the association between BTM levels and clinical variables, spinal syndesmophytes, and BMD using multivariate analysis. METHOD Seventy-eight AS patients were compared with 58 HC matched by gender. Spinal syndesmophytes in AS and other characteristics were assessed. C-terminal telopeptide fragments of type I collagen (CTX), bone-specific alkaline phosphatase (BAP), osteocalcin (OC) serum levels, and BMD of the lumbar spine, femoral neck, and forearm were evaluated. RESULTS AS males and females had lower BAP levels than their respective HC (p < 0.001 and p = 0.001). AS patients with bridging syndesmophytes had higher OC levels than AS patients either with non-bridging syndesmophytes (p = 0.001) or without spinal syndesmophytes (p < 0.001). OC and CTX levels correlated significantly with the modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS). In the multivariate linear regression adjusted by age, gender, the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), BMD in the lumbar spine, and C-reactive protein (CRP), we observed an association between BAP levels and anti-tumour necrosis factor (anti-TNF) use (p = 0.05) whereas OC levels were associated with mSASSS (p < 0.001) and anti-TNF use (p = 0.05), and CTX levels were exclusively associated with mSASSS (p = 0.03). In the logistic regression analysis, only OC levels were associated with the presence of syndesmophytes in AS [odds ratio (OR) 2.42, 95% confidence interval (CI) 1.19-5.75]. CONCLUSIONS We observed an increase in OC levels in AS patients with syndesmophytes. BTM levels were associated with the severity of spinal damage. Future longitudinal studies should evaluate whether these BTMs should be included as tools to determine the prognosis and progression of spinal damage.
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Affiliation(s)
- J I Gamez-Nava
- a Research Unit in Clinical Epidemiology, Specialties Hospital of the National Occidental Medical Centre , Mexican Social Security Institute (IMSS) , Guadalajara , Jalisco , Mexico
| | - L F de la Cerda-Trujillo
- b University Centre of Health Sciences , University of Guadalajara , Guadalajara , Jalisco , Mexico
| | - M L Vazquez-Villegas
- c Department of Epidemiology, Familiar Medicine Unit 4-8, IMSS and University Centre of Health Sciences , University of Guadalajara , Guadalajara , Jalisco , Mexico
| | - F Cons-Molina
- d Research Centre of Arthritis and Osteoporosis , Mexicali , Baja California , Mexico
| | - M F Alcaraz-Lopez
- e Department of Internal Medicine-Rheumatology, Hospital General Regional 45 , IMSS , Guadalajara , Jalisco , Mexico
| | - S A Zavaleta-Muñiz
- f Faculty of Medicine , University of Juárez del Estado de Durango , Gómez Palacio , Durango , Mexico
| | - A D Rocha-Muñoz
- g University Centre of Tonala , University of Guadalajara , Tonala , Jalisco , Mexico
| | - E A Martinez-Garcia
- h Research Institute of Rheumatology and Skeletal Muscle System , University Centre of Health Sciences, University of Guadalajara , Guadalajara , Jalisco , Mexico
| | - E G Corona-Sanchez
- h Research Institute of Rheumatology and Skeletal Muscle System , University Centre of Health Sciences, University of Guadalajara , Guadalajara , Jalisco , Mexico
| | - M Salazar-Paramo
- i Division of Health Research, Hospital of the National Occidental Medical Centre , IMSS , Guadalajara , Jalisco , Mexico
| | - N S Fajardo-Robledo
- j Postdoctoral Fellow Research Program of Postgraduate in Medical Sciences University of Colima, Colima Mexico and LIDF, CUCEL University of Guadalajara , Guadalajara , Mexico
| | - E M Olivas-Flores
- k Department of Anaesthesiology, Specialties Hospital of the Western National Medical Centre , IMSS , Guadalajara , Jalisco , Mexico
| | - E G Cardona-Muñoz
- l Department of Physiology, University Centre of Health Sciences , University of Guadalajara , Guadalajara , Jalisco , Mexico
| | - L Gonzalez-Lopez
- m Department of Internal Medicine-Rheumatology , Hospital General Regional 110, IMSS, Guadalajara, Jalisco, Mexico and CUCS University of Guadalajara , Guadalajara , Jalisco , Mexico
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Clark P, Cons-Molina F, Deleze M, Talavera JO, Palermo L, Cummings SO. The prevalence of radiographic vertebral fractures in Mexican men. Osteoporos Int 2010; 21:1523-8. [PMID: 19936869 PMCID: PMC2912720 DOI: 10.1007/s00198-009-1109-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2009] [Accepted: 09/21/2009] [Indexed: 10/25/2022]
Abstract
SUMMARY The prevalence of radiographically ascertained vertebral fractures in a random sample of 413 in Mexican men is 9.7% (95% CI 6.85-12.55). Increase of vertebral fracture rises with age from 2.0% in the youngest group (50-59 years) to 21.4% in the oldest group (80 years and over). INTRODUCTION This is the first population-based study of vertebral fractures in Mexican men using a standardized methodology reported in other studies. METHODS The presence of radiographic vertebral fractures increases with age. This same pattern was found in Mexican women with steady age increments, but the higher prevalence of fractures in women starts at age 70, whereas in men, the higher prevalence starts a decade later (80 years and over). RESULTS The standardized prevalence per 1,000 men 50 years and over in the Mexican population for the year 2005 is 65.8 (95% CI 29.9-105.5), and it is 68.6 (95% CI 32.2-108.7) in the US population for the year 2000.
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Affiliation(s)
- P Clark
- Clinical Epidemiology Unit, Hospital Infantil de Mexico Federico Gómez-Faculty of Medicine UNAM, Blvd. Virreyes 1010, Lomas de Chapultepec, Mexico City 11000 DF, Mexico.
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Clark P, Cons-Molina F, Deleze M, Ragi S, Haddock L, Zanchetta JR, Jaller JJ, Palermo L, Talavera JO, Messina DO, Morales-Torres J, Salmeron J, Navarrete A, Suarez E, Pérez CM, Cummings SR. The prevalence of radiographic vertebral fractures in Latin American countries: the Latin American Vertebral Osteoporosis Study (LAVOS). Osteoporos Int 2009; 20:275-82. [PMID: 18584111 DOI: 10.1007/s00198-008-0657-4] [Citation(s) in RCA: 93] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2007] [Accepted: 05/05/2008] [Indexed: 11/24/2022]
Abstract
UNLABELLED In the first population-based study of vertebral fractures in Latin America, we found a 11.18 (95% CI 9.23-13.4) prevalence of radiographically ascertained vertebral fractures in a random sample of 1,922 women from cities within five different countries. These figures are similar to findings from studies in Beijing, China, some regions of Europe, and slightly lower than those found in the USA using the same standardized methodology. INTRODUCTION We report the first study of radiographic vertebral fractures in Latin America. METHODS An age-stratified random sample of 1,922 women aged 50 years and older from Argentina, Brazil, Colombia, Mexico, and Puerto Rico were included. In all cases a standardized questionnaire and lateral X-rays of the lumbar and thoracic spine were obtained after informed consent. RESULTS A standardized prevalence of 11.18 (95% CI 9.23-13.4) was found. The prevalence was similar in all five countries, increasing from 6.9% (95% CI 4.6-9.1) in women aged 50-59 years to 27.8% (95% CI 23.1-32.4) in those 80 years and older (p for trend < 0.001). Among different risk factors, self-reported height loss OR = 1.63 (95% CI: 1.18-2.25), and previous history of fracture OR = 1.52 (95% CI: 1.14-2.03) were significantly (p < 0.003 and p < 0.04 respectably) associated with the presence of radiographic vertebral fractures in the multivariate analysis. In the bivariate analyses HRT was associated with a 35% lower risk OR = 0.65 (95% CI: 0.46-0.93) and physical activity with a 27% lower risk of having a vertebral fracture OR = 0.73 (95% CI: 0.55-0.98), but were not statistically significant in multivariate analyses CONCLUSION We conclude that radiographically ascertained vertebral fractures are common in Latin America. Health authorities in the region should be aware and consider implementing measures to prevent vertebral fractures.
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Affiliation(s)
- P Clark
- Clinical Epidemiology Unit, CMN Siglo XXI, IMSS Faculty of Medicine UNAM, Lomas de Chapultepec, DF, Mexico City, Mexico.
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Delezé M, Cons-Molina F, Villa AR, Morales-Torres J, Gonzalez-Gonzalez JG, Calva JJ, Murillo A, Briceño A, Orozco J, Morales-Franco G, Peña-Rios H, Guerrero-Yeo G, Aguirre E, Elizondo J. Geographic differences in bone mineral density of Mexican women. Osteoporos Int 2000; 11:562-9. [PMID: 11069189 DOI: 10.1007/s001980070076] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The aim of this study was to generate standard curves for normal spinal and femoral neck bone mineral density (BMD) in Mexican women using dual-energy X-ray absorptiometry (DXA), to analyze geographic differences and to compare these with 'Hispanic' reference data to determine its applicability. This was a cross-sectional study of 4460 urban, clinically normal, Mexican women, aged 20-90 years, from 10 different cities in Mexico (5 in the north, 4 in the center and 1 in the southeast) with densitometry centers. Women with suspected medical conditions or who had used drugs affecting bone metabolism, were excluded. Lumbar spine BMD was significantly higher (1.089 +/- 0.18 g/cm2) in women from the northern part of Mexico, with intermediate values in the center (1.065 +/- 0.17 g/cm2) and lower values (1.013 +/- 0.19 g/cm2) in the southeast (p < 0.0001). Similarly, femoral neck BMD was significantly higher in women from the north (0.895 +/- 0.14 g/cm2), intermediate in the center (0.864 +/- 0.14 g/cm2) and lower (0.844 +/- 0.14 g/cm ) in the southeast part of Mexico (p < 0.0001). Northern Mexican women tend to be taller and heavier than women from the center and, even more, than those from the southeast of Mexico (p < 0.0001). However, these differences in BMD remained significant after adjustment for weight (p < 0.0001). A significant loss (p < 0.0001) in BMD was observed from 40 to 69 years of age at the lumbar spine and up to the eighth decade at the femoral neck. Higher and lower lumbar spine values, as compared with the 'Hispanic' population, were observed in Mexican mestizo women from the northern and southeastern regions, respectively. In conclusion, there are geographic differences in weight and height of Mexican women, and in BMD despite adjustment for weight.
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Affiliation(s)
- M Delezé
- Clínica de osteoporosis del Centro de Hematología y Medicina Intema de Puebla, PUE, Mexico.
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