Park Min-Chan, Chung Soo-Jin, Park Yong-Beom, Lee Soo-Kon
Division of Rheumatology, Department of Internal Medicine, Institute for Immunology and Immunologic Diseases, Yonsei University College of Medicine, 250 Seongsanno, Seodaemun-gu, Seoul 120-752, Korea.
Yonsei Med J. 2008 Apr 30;49(2):288-94. doi: 10.3349/ymj.2008.49.2.288.
To determine the levels of bone and cartilage turnover markers in men with ankylosing spondylitis (AS) and to investigate their associations with disease activity, bone mineral density, and radiographic damage of the spine.
This cross-sectional study enrolled 35 men with newly diagnosed AS. The bone mineral densities (BMD) of their lumbar spines and proximal femurs, Bath AS Disease Activity Index (BASDAI), and Bath AS Radiographic Index (BASRI) were evaluated. Urinary C-terminal telopeptide fragments of type I collagen (CTX-I) and type II collagen (CTX-II) levels were determined by enzyme-linked immunosorbent assay, and serum levels of bone-specific alkaline phosphatase (BALP) and osteocalcin were determined by an enzyme immunoassay. Levels of biochemical markers were compared with those of 70 age-matched healthy men.
Patients with AS had significantly higher mean urinary CTX-I and CTX-II levels than control subjects (p<0.05). Elevated urinary CTX-I levels correlated well with BASDAI, femoral BMD, and femoral T score (p<0.05), and elevated urinary CTX-II levels correlated well with spinal BASRI (p<0.05) in patients with AS. Mean serum BALP and osteocalcin levels did not differ between patients and controls and did not show any significant correlations with BMD, BASDAI, or BASRI in men with AS.
Elevated CTX-I reflects disease activity and loss of femoral BMD while elevated CTX-II levels correlate well with radiographic damage of the spine, suggesting the usefulness of these markers for monitoring disease activity, loss of BMD, and radiographic damage in men with AS.
测定强直性脊柱炎（AS）男性患者的骨和软骨转换标志物水平，并研究其与疾病活动度、骨密度及脊柱影像学损害之间的关联。
这项横断面研究纳入了35例新诊断的AS男性患者。评估其腰椎和股骨近端的骨密度（BMD）、巴斯强直性脊柱炎疾病活动指数（BASDAI）以及巴斯强直性脊柱炎放射学指数（BASRI）。采用酶联免疫吸附测定法测定尿I型胶原C端肽片段（CTX-I）和II型胶原C端肽片段（CTX-II）水平，采用酶免疫测定法测定血清骨特异性碱性磷酸酶（BALP）和骨钙素水平。将生化标志物水平与70例年龄匹配的健康男性进行比较。
AS患者的尿CTX-I和CTX-II平均水平显著高于对照组（p<0.05）。在AS患者中，尿CTX-I水平升高与BASDAI、股骨BMD和股骨T值密切相关（p<0.05），尿CTX-II水平升高与脊柱BASRI密切相关（p<0.05）。患者与对照组的血清BALP和骨钙素平均水平无差异，且在AS男性患者中与BMD、BASDAI或BASRI均无显著相关性。
CTX-I升高反映疾病活动度及股骨骨密度丢失，而CTX-II水平升高与脊柱影像学损害密切相关，提示这些标志物对监测AS男性患者的疾病活动度、骨密度丢失及影像学损害具有一定作用。
