Life quality of men with ankylosing spondylitis: association with the disease course and the structural and functional state of bone tissue

Abstract

Abstract. Background. Multiple peculiarities of ankylosing spondylitis clinical course have a significant influence on the physical, mental and social status of patients. Systemic loss of bone tissue manifesting itself through the development of osteoporosis and its complications is not excluded either. However, currently there is no sufficiently clear information on the influence of osteoporosis or its metabolic components, as well as peculiarities of the disease clinical course on the physical and mental health components in the patients suffering from ankylosing spondylitis. Purpose: to study the quality of life indices using the SF-36 and HAQ questionnaires in men suffering from ankylosing spondylitis and to assess the associations of these indexes with the disease clinical course as well as structural and functional state of bone tissue. Materials and methods. 105 men suffering from ankylosing spondylitis and 25 practically healthy persons of the appropriate age and sex forming the control group were examined. In order to assess the quality of life indices, the SF-36 and HAQ questionnaires were used. Results. It was established that men suffering from ankylosing spondylitis showed reliably lower indices of physical (37.3 ± 1.5 points) and mental (44.2 ± 1.7 points) health components if compared to the control group (99.1 ± 0.3; 97.4 ± 0.7 points respectively). Under conditions of the low bone mineral density, quality of life indices (PCS; MCS) were only 12.2–7.1 % lower than in the patients with a preserved bone mineral density. It was shown that under conditions of the Vitamin D deficiency, quality of life components were significantly worse, specifically on account of the mental health component (р < 0.05). It was also established that the lower quality of life was closely associated with a high activity of the inflammatory process (ASDAS-СRP, BASDAI) and a high dose of glucocorticoids. Conclusions. Men suffering from ankylosing spondylitis show a significant reduction of life quality indices by the SF-36 (PCS; MCS) and HAQ questionnaires, which demonstrate no association with the age of the patients (except for MCS), disease form and duration, structural and functional state of bone tissue. However, they are significantly worse in subjects with the Vitamin D deficiency, a high dose of glucocorticoids and high disease activity.