Osteoporoza i ankilozantni spondilitis

master's thesis

• Title (english): Osteoporosis and ankylosing spondylitis
• Author: Amalija Andreić
• Mentor: Nadica Laktašić Žerjavić (mentor)
• Committee member: Porin Perić (predsjednik povjerenstva)
• Committee member: Marija Bakula (član povjerenstva)
• Committee member: Nadica Laktašić Žerjavić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Physical Medicine and General Rehabilitation); Zagreb
• Defense date and country: 2024-09-11, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Physical Medicine and Rehabilitation

Abstract

Osteoporoza je metabolička bolest kostiju koju također prati smanjena gustoća kostiju. Najčešće se javlja u starijoj populaciji i to obično kod žena u postmenopauzi, te kao komplikacija drugih koštanih ili izvankoštanih bolesti. Često dovodi do osteoporotičnih prijeloma koji nastaju već pri maloj ili neznatnoj traumi. Ankilozantni spondilitis (AS) je kronična upalna bolest s tendencijom progresije. Zahvaća aksijalni skelet, i to posebice kralješke i sakroilijakalne zglobove. U općoj populaciji njena prevalencija iznosi oko 0,2%, te se češće javlja kod muškaraca mlađe dobi. Pokazuje jaku povezanost s HLA-B27 antigenom. Kronična upala zajedno s brojnim upalnim citokinima dovodi do oštećenja mikroarhitekture kostiju. Time se smanjuje mineralna gustoća kosti i povećava rizik za pojavu osteoporoze, koja je i jedna od komplikacija AS-a. Ako se osteoporoza javi u bolesnika s AS-om, dolazi to dodatnog povećavanja rizika za prijelome. Međutim, za razliku od osteoporotičnih prijeloma u postmenopauzi, ovi prijelomi češće zahvaćaju vratnu kralježnicu uz jače izraženu kliničku sliku, a mogu dovesti i do neuroloških ispada. Najvažniji rizični čimbenici koji pogoduju razvoju osteoporoze u AS bolesnika su kronična upala (posebno važni proupalni citokini TNF-α, IL-1 i IL-6) koja stimulira razgradnju kosti te smanjena tjelesna aktivnost zbog ankiloze kralježaka. Prijelomi su razlog povećanog mortaliteta u usporedbi s zdravom populacijom, a liječe se imobilizacijom ili kirurški. Dijagnoza prijeloma je otežana jer se oni na RTG-u zbog obilja osteofita često teško uočavaju, tako da je glavna dijagnostička metoda CT.

Abstract (english)

Osteoporosis is a metabolic bone disease that is also accompanied by reduced bone density. It most often occurs in the elderly population, frequently in postmenopausal women, and as a complication of other bone or extra-osseous diseases. Osteoporosis often causes osteoporotic fractures that occur even with mild or minor trauma. Ankylosing spondylitis (AS) is a chronic inflammatory disease with a tendency to progression. It affects the axial skeleton, especially the vertebral and sacroiliac joints. In the general population, its prevalence is about 0.2%, and it occurs more often in younger men. It shows a strong association with the HLA-B27 antigen. Chronic inflammation associated with numerous inflammatory cytokines lead to bone microarchitecture damage. This reduces bone mineral density and increases the risk of osteoporosis, the latter being one of the complications of AS. If osteoporosis occurs in patients with AS, it further increases the risk of fractures. However, unlike postmenopausal osteoporotic fractures, these fractures more often affect the cervical spine with more pronounced symptoms, and can also lead to neurological dysfunction. The most important risk factors favoring the development of osteoporosis in AS patients are chronic inflammation (especially important pro-inflammatory cytokines TNF-alpha, IL-1, and IL-6) which stimulate bone breakdown, and reduced physical activity due to vertebral ankylosis. Fractures are the cause of increased mortality compared to the healthy population, and are treated with immobilization or surgery. The diagnosis of fractures is difficult because they are hard to identify on X-ray, due to the abundance of osteophytes. Hence, CT is the method of choice.

• Keywords: ankilozantni spondilitis; osteoporoza; prijelomi kralježnice; osteofiti; koštana gustoća
• Keywords (english): ankylosing spondylitis; osteoporosis; vertebral fractures; osteophytes; bone density
• Language: croatian
• URN:NBN: urn:nbn:hr:105:439637
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2024-07-24 12:48:56