الفهرس 
ANKYLOSING SPONDYLITISOnly 14 pages are availabe for public view
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Abstract
Ankylosing spondylitis (AS) is a chronic rheumatic disease characterized by inflammation and extensive remodeling of spine and joints. In contrast to rheumatoid arthritis, destructive changes are limited in AS, but extensive new bone formation results in the development of spinal syndesmophytes and extra-articular enthesophytes, leading to joint or spine ankyloses. Parallel to the osteoproliferation, patients with AS also have an increased loss of bone, resulting in an elevated risk for vertebral fractures.
The excess bone loss and vertebral fractures might be related to the activity of the Wingless signaling pathway, and in particular with the serum levels of its circulating inhibitor, Dickkopf-1 (DKK1).
The aim of this study is to measure the serum level of Dickkopf-1 (DKK1) in patients with ankylosing spondylitis (AS) and study its relation to vertebral fractures, bone mineral density and disease activity.
A total of 80 subjects 40 patients diagnosed AS according to modified New York (mNY) criteria Who had attended the outpatient clinic of Physical Medicine, Rheumatology and Rehabilitation Department, Menoufia University Hospitals, from 2018 to 2020 and 40 healthy sex and age matched volunteers as controls were included in this study after gave ethical written consent about our study according to Menofiya University Ethical Committee & accepted from ethical committee.
Patients with inflammatory bowel disease, psoriasis, diabetes mellitus, hepatic and renal diseases and who had spinal deformities or did previous spinal surgery, also patients on hormonal or corticosteroid therapy all were excluded from this study.
The patients group were subjected to the following:
• Full medical history
Name - age – sex – occupation - smoking or alcohol consumption and disease duration.
• Clinical examination:
• General examination
• Pulse, Blood pressure, chest, heart and abdominal examination.
• Local examination of joints:
• Examination of lumbosacral and cervical spine.
• Examination of peripheral joints to detect peripheral joint involvement.
• Assesment of disease activity
By applying
• Bath Ankylosing Spondylitis Disease Activity Index (BASDAI).
• Bath Ankylosing Spondylitis Functional Index (BASFI).
• Modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS).
• Laboratory investigations:
• HALA B-27
• Complete blood picture (CBC).
• Erythrocyte sedimentation rate (ESR).
• C- reactive protein (CRP) titer.
• Total and Serum ionized calcium.
• Random blood sugar.
• Parathyroid hormone.
• Thyroxine hormone.
Patients and controls were subjected to the following:
• Serum dickkopf-1 level detection.
Radiological examination:-
• Dual energy x-ray absorptiometry (DEXA) on lumbosacral spine.
• Plain x-ray spine lateral view according to Genant semi quantitative method to detect presence of vertebral fractures.
• Statistical analysis of data.