Department of Physical Medicine and Rehabilitation, Ankara Numune Education and Research Hospital, 9/16 Emek, Ankara, Turkey.
Rheumatol Int. 2009 Oct;29(12):1435-9. doi: 10.1007/s00296-009-0875-x. Epub 2009 Mar 15.
In this study serum homocystein (Hcy) level was measured and its relationship with disease activity criteria and treatment protocols was investigated in ankylosing spondylitis (AS) patients. Ninety-two AS patients and 58 healthy individuals were recruited. Erythrocyte sedimentation rate and serum C-reactive protein were determined. Bath AS disease activity index and Bath AS functional index were calculated. Serum Hcy levels >15 micromol/l were considered as hyperhomocysteinemia. The mean serum homocysteine levels were 14.40 and 12.60 micromol/l in patients with AS and the control group, respectively, and the difference between two groups was significant. While there was no significant difference between the sulfasalazine (SSZ) group with 14.25 micromol/l mean Hcy level and the methotrexate (MTX)/SSZ group with 16.05 micromol/l, there was a statistically significant difference between the Hcy levels of these two groups and Hcy level of 12.15 micromol/l of the non-steroidal anti-inflammatory drugs group, and 12.60 micromol/l Hcy level of the control group. Mean serum Hcy level was 13.65 micromol/l in patients with active AS and 14.60 micromol/l in patients with inactive AS, and there was no significant difference between the groups. In our study serum Hcy level was found to be significantly higher in patients with AS than in healthy control subjects. Especially for the AS patients receiving MTX and SSZ treatment without folic acid supplementation, addition of folic acid to their therapy may decrease the risk of cardiovascular disease which in turn decreases the mortality in these patients, but further prospective studies are needed for supporting these results.
本研究测定了血清同型半胱氨酸（Hcy）水平，并探讨了其与强直性脊柱炎（AS）患者的疾病活动标准和治疗方案的关系。共招募了 92 例 AS 患者和 58 名健康对照者。测定红细胞沉降率和血清 C 反应蛋白。计算 Bath AS 疾病活动指数和 Bath AS 功能指数。血清 Hcy 水平＞15 μmol/L 被认为是高同型半胱氨酸血症。AS 患者和对照组的平均血清同型半胱氨酸水平分别为 14.40 和 12.60 μmol/L，两组间差异有统计学意义。虽然柳氮磺胺吡啶（SSZ）组的平均 Hcy 水平为 14.25 μmol/L 与甲氨蝶呤（MTX）/SSZ 组的 16.05 μmol/L 之间无显著差异，但与非甾体抗炎药组的 12.15 μmol/L 和对照组的 12.60 μmol/L 相比，这两组的 Hcy 水平差异有统计学意义。活动期 AS 患者的平均血清 Hcy 水平为 13.65 μmol/L，非活动期 AS 患者为 14.60 μmol/L，两组间无显著差异。在本研究中，我们发现 AS 患者的血清 Hcy 水平明显高于健康对照组。特别是对于接受 MTX 和 SSZ 治疗且未补充叶酸的 AS 患者，在其治疗中添加叶酸可能会降低心血管疾病的风险，从而降低这些患者的死亡率，但需要进一步的前瞻性研究来支持这些结果。
