The Impact of Osteoporosis in Patients with Ankylosing Spondylitis and Its Relationship to Physical Activity

Abstract

Background: Osteoporosis (OP) is a major fracture risk in ankylosing spondylitis (AS), and there are few qualitative reports on bone massin AS. Objective: The aim of this study was to correlate the bone mineral density (BMD) with disease activity and physical activity (PA)in AS. Materials and Methods: Sixty-two participants who met the criteria for diagnosis of AS (28 males and 34 females) were recruitedfrom Al-Yarmouk Teaching Hospital Baghdad, Iraq. The study was conducted at baseline and after 6 months of exercises. European healthrelatedquality of life was used to reflect physical function. The erythrocyte sedimentation rate and C-reactive protein were used to evaluateAS disease as markers for disease activity. The study measured BMD at two events, before and after performing the relevant exercise.Results: Results found that 9.6% of patients reported fractures. Low bone mass in the AS patients were 17 (27%) in number. Osteopenicpatients were 9 (14%) in number, while osteoporotic patients were 8 (13%) in number. An association (P = 0.05) between BMD and PA wasnoticed in AS participants. There was a weak (P ˂ 0.055) significant association of higher European health-related quality of life scores withlower spinal and hip BMD. No association of AS disease activity with BMD was found, although bone loss in AS is common in persistentactive disease; regular PA seems to be a positive factor for improving bone quantity and prevent fracture. Programmed exercise promoteshealthy bone. The severity of AS in Iraq is less than the other countries. Conclusion: PA in AS patients has a positive effect on bone status.This implies that AS disease-related loss in BMD is preventable by the relevant exercise program. This information is important, as it can beutilized while designing preventive and treatment plans for AS patients.