Older Female Ankylosing Spondylitis Patients With Dyslipidemia, More Prone to Osteoporosis

Overall, patients with ankylosing spondylitis (AS) are more likely to develop osteoporosis compared to the general population, a new study shows.

However, the risk is particularly high for AS patients who are female, older than 65, and have abnormal fat levels in the blood (dyslipidemia).

The study with those findings, “Should clinicians pay more attention to the potential underdiagnosis of osteoporosis in patients with ankylosing spondylitis? A national population-based study in Taiwan,” was published in the journal Plos One.

AS is a chronic inflammatory disease that affects the spine. Patients with AS are known to be at a higher risk for several other diseases, including osteoporosis.

Osteoporosis is a musculoskeletal disease that is characterized by reduced bone mineral density (BMD) and bone fragility. Studies have suggested that osteoporosis is relatively common in AS patients because both diseases share common mechanisms of systemic inflammation and low BMD as a result of being unable to carry out physical activities (due to stiffness and pain).

“[S]tudies have indicated that patients with AS are at increased risk of osteoporosis and subsequent osteoporotic fractures due to bone fragility,” researchers wrote.

However, there appears to be significant variance in the prevalence of osteoporosis in AS patients, ranging from 13% to 32%. This is likely due to the differences in different populations.

Researchers conducted a study to investigate the association between AS and osteoporosis in a Taiwanese population. Researchers also sought to investigate potential risk factors and the incidence of new-onset osteoporosis among AS patients in Taiwan.

The team used data from the Taiwan National Health Insurance Research Database (NHIRD). The study included 10,290 participants: 2,058 AS patients and 8,232 individuals without AS.

Researchers used statistical models to estimate the risk of osteoporosis in AS patients after controlling for demographics and other comorbidities.

Individuals with AS were 2.17-fold more likely to develop osteoporosis than those without AS. After controlling for demographic characteristics and comorbid medical disorders, the risk of developing osteoporosis was still 1.99-fold higher for people with AS compared to those without the disease.

Next, researchers looked at individual risk factors for the development of osteoporosis in AS patients. They found that patients who were females, 65 years or older, or had dyslipidemia had a 2.48-, 4.32-, and 1.44-fold higher risk of developing osteoporosis, respectively.

“Given that the underestimation of osteoporosis in AS patients can have serious health consequences, a greater emphasis should be placed on this association,” researchers concluded.