ÖZET
Ankilozan spondilitli (AS) hastalar, kemik frajilitesi nedeni ile osteoporoz (OP) ve kırık gelişimi açısından artmış risk altındadırlar. AS varlığı, OP gelişimi açısından risk oluşturmakla birlikte, AS hastalarında OP taramasına yönelik bir kılavuz bulunmamaktadır ve genç erkek hastalar daha da nadir taranmaktadır. AS hastalarında OP tanısının gözden kaçırılmasının ciddi sonuçları olabileceği gözönüne alındığında, bu ilişkinin önemi daha da belirginleşmektedir. AS hastalarında vertebral fraktür gelişimi açısından risk faktörleri femur total ve femur boynunda saptanan düşük kemik mineral yoğunluğu (KMY), erkek cinsiyet, uzun hastalık süresi, yüksek hastalık semptom skorları, enflamatuvar barsak hastalığı varlığı ve hastalığa bağlı deformitelerin fazla olmasıdır. Lomber KMY ile ilişki yoktur. OP gelişimi açısından ana patofizyolojik mekanizma, sistemik enflamasyonun yanı sıra, ağrı, ankiloz ve tutukluğa bağlı azalmış fiziksel aktivite ve buna bağlı düşük KMY’dir. AS hastalarında kemik ve KMY üzerine interleukin (IL)-17, IL-23 aksı, tümör nekrozis faktör--α ve barsak immünopatobiyolojisinin etkilerine dair de kanıtlar mevcuttur.
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