Abstract
Objectives: This study aimed to investigate the relationship between bone mineral density (BMD) and various body composition parameters in Vietnamese patients with SpA.
Methods: A case-control study was conducted at Hue University of Medicine and Pharmacy University Hospital, Vietnam, involving 43 patients with SpA and 71 age-, sex-, and BMI-matched healthy controls. Dual-energy X-ray absorptiometry (DXA) was used to assess body composition, measuring BMD and Z-scores at the lumbar spine, femoral neck, and total hip. Additional parameters included muscle mass index (appendicular skeletal muscle mass (ASM), appendicular skeletal muscle mass index (ASMI), body fat percentage (BF%), and fat mass index (FMI). Multivariable linear regression models were used to analyze the associations between BMD and body composition variables, with mean differences and 95% confidence intervals calculated.
Results: SpA patients had significantly reduced BMD in the lumbar spine and total hip compared to the healthy control group. Furthermore, significant positive correlations were observed between femoral neck BMD and both ASM (r=0.304, p=0.047) and ASMI (r=0.319, p=0.037), as well as between total hip BMD and ASMI (r=0.307, p=0.045).
Conclusions: The findings highlight the importance of monitoring BMD in patients with SpA due to the observed bone loss. Further research is warranted to fully elucidate the complex interplay between inflammation, body composition, and bone health in SpA.
| Published | 2026-04-30 | |
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| Issue | Vol. 16 No. 02 (2026) | |
| Section | Original Articles | |
| DOI | 10.34071/jmp.2026.2.1008 | |
| Keywords | Body composition, bone mineral density, Spondyloarthritis, Vietnam |

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Copyright (c) 2026 Hue Journal of Medicine and Pharmacy
Akgul O, Ozgocmen S. Classification criteria for spondyloarthropathies. World J Orthop. 2011;2(12):107-15.
Aguiar R, Sequeira J, Meirinhos T, Ambrósio C, Barcelos A. SARCOSPA - Sarcopenia in spondyloarthritis patients. Acta Reumatol Port. 2014;39(4):322-6.
Hu J, Wang Y, Ji X, Zhang Y, Li K, Huang F. The prevalence of sarcopenia in spondyloarthritis patients: a meta-analysis. Arthritis Res Ther. 2024;26(1):72.
Ramírez J, Nieto-González JC, Curbelo Rodríguez R, Castañeda S, Carmona L. Prevalence and risk factors for osteoporosis and fractures in axial spondyloarthritis: A systematic review and meta-analysis. Semin Arthritis Rheum. 2018;48(1):44-52.
Hu LY, Lu T, Chen PM, Shen CC, Hung YM, Hsu CL. Should clinicians pay more attention to the potential underdiagnosis of osteoporosis in patients with ankylosing spondylitis? A national population-based study in Taiwan. PLoS One. 2019;14(2):e0211835.
Jiang Y, Zhang P, Tu L, Lv Q, Qi J, Lin Z, et al. Prevalence of comorbidities and evaluation of screening in Chinese patients with spondyloarthritis. Clin Rheumatol. 2018;37(2):423-8.
van der Weijden MA, van Denderen JC, Lems WF, Heymans MW, Dijkmans BA, van der Horst-Bruinsma IE. Low bone mineral density is related to male gender and decreased functional capacity in early spondylarthropathies. Clin Rheumatol. 2011;30(4):497-503.
Hu L, Ji X, Wang Y, Man S, Liu X, Wang L, et al. Underweight and obesity are strong predictors of clinical outcomes in patients with ankylosing spondylitis: data from the Smart-phone SpondyloArthritis Management System. Ther Adv Musculoskelet Dis. 2021;13:1759720x211030792.
Lacativa PG, Farias ML. Osteoporosis and inflammation. Arq Bras Endocrinol Metabol. 2010;54(2):123-32.
Bindesbøll C, Garrido-Cumbrera M, Bakland G, Dagfinrud H. Obesity Increases Disease Activity of Norwegian Patients with Axial Spondyloarthritis: Results from the European Map of Axial Spondyloarthritis Survey. Curr Rheumatol Rep. 2020;22(8):43.
Ibáñez Vodnizza S, Visman IM, van Denderen C, Lems WF, Jaime F, Nurmohamed MT, et al. Muscle wasting in male TNF-α blocker naïve ankylosing spondylitis patients: a comparison of gender differences in body composition. Rheumatology (Oxford). 2017;56(9):1566-72.
Kaffel D, Makhlouf Y, Maatallah K, Ferjani H, Abaza N, Hamdi W. Impact of Lean and Fat Mass on Disease Activity and Function in Spondyloarthritis. Curr Rheumatol Rev. 2022;18(3):243-9.
Merle B, Cottard M, Sornay-Rendu E, Szulc P, Chapurlat R. Spondyloarthritis and Sarcopenia: Prevalence of Probable Sarcopenia and its Impact on Disease Burden: The Saspar Study. Calcif Tissue Int. 2023;112(6):647-55.
Kanjanavaikoon N, Saisirivechakun P, Chaiamnuay S. Age, body mass index, and function as the independent predictors of sarcopenia in axial spondyloarthritis: a cross-sectional analysis. Clin Rheumatol. 2023;42(12):3257-65.
Duc Anh D., Hoai Thu Ph. Sarcopenia and some related factors in patients with ankylosing spondilitis. Vietnam Medical Journal. 2023;533(2):199-203.
S Inoue, P Zimmet, al. e. The Asia-Pacific perspective: Redefining Obesity and its Treatment. World Health Organization Western Pacific Region; 2000.
Lewiecki EM, Gordon CM, Baim S, Leonard MB, Bishop NJ, Bianchi ML, et al. International Society for Clinical Densitometry 2007 Adult and Pediatric Official Positions. Bone. 2008;43(6):1115-21.
Proft F, Schally J, Brandt HC, Brandt-Juergens J, Rüdiger Burmester G, Haibel H, et al. Validation of the ASDAS with a quick quantitative CRP assay (ASDAS-Q) in patients with axial SpA: a prospective multicentre cross-sectional study. Ther Adv Musculoskelet Dis. 2022;14.
El Maghraoui A, Ebo’o FB, Sadni S, Majjad A, Hamza T, Mounach A. Is there a relation between pre-sarcopenia, sarcopenia, cachexia and osteoporosis in patients with ankylosing spondylitis? BMC Musculoskelet Disord. 2016;17:268.
Singh HJ, Nimarpreet K, Ashima, Das S, Kumar A, Prakash S. Study of bone mineral density in patients with ankylosing spondylitis. J Clin Diagn Res. 2013;7(12):2832-5.
Kim HR, Hong YS, Park SH, Ju JH, Kang KY. Low bone mineral density predicts the formation of new syndesmophytes in patients with axial spondyloarthritis. Arthritis Res Ther. 2018;20(1):231.
Kaya A, Ozgocmen S, Kamanli A, Ardicoglu O. Bone loss in ankylosing spondylitis: does syndesmophyte formation have an influence on bone density changes? Med Princ Pract. 2009;18(6):470-6.
Alvarez-Ayala EG, Gamez-Nava JI, Saldana-Cruz AM, Gonzalez-Ponce F, Contreras-Haro B, Ramirez-Villafana M, et al. Bone Mineral Density and Serum Levels of Bone Remodeling Markers in Ankylosing Spondylitis Treated with Anti TNF-alpha Agents. Med Sci (Basel). 2025;13(3).







