Department of Rheumatology, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea.
Joint Bone Spine. 2013 Oct;80(5):488-91. doi: 10.1016/j.jbspin.2012.12.003. Epub 2013 Jan 30.
To evaluate the influence of homozygosity for HLA-B27 on the radiographic damage in ankylosing spondylitis (AS).
A total of 368 AS patients with positive HLA-B27 status from the Observation Study of Korean spondyloArthropathy Registry (OSKAR) cohort were recruited for this study. HLA-B27 positive patients out of all AS patients were assessed for whether they had homozygosity or heterozygosity for HLA-B27. First, all data were stratified in relation to the carrier state of positive HLA-B27 for cross-sectional survey. Then we compared the radiographic damage score between groups. Second, we evaluated collected clinical and radiographic parameters at two different time points. Then we compared radiographic progression between groups. To use the mSASSS, cervical and lumbar spinal radiographs were examined by two experienced bone and joint radiologists (S. Lee, K.B. Joo).
The agreement between the two readers regarding mSASSS was very good: ICC coefficient 0.70 (95% CI 0.60-0.81). The mean age (SD) of the AS patients was 37.0 (9.2) years, and the mean disease duration (SD) was 15.6 (9.1) years. Of these patients, 34.5% (127 patients) had HLA-B27 homozygosity. The mean mSASSS unit (SEM) was not significantly different between groups (homozygosity 28.57±4.12 vs heterozygosity 23.34±3.44, P=0.344) on cross-sectional survey. When it comes to radiographic progression between groups over 5 years, there was no significant difference in spite of adjusting for confounding variable (homozygosity 4.98±0.98 vs heterozygosity 4.21±0.82, P=0.562).
The carrier state of positive HLA-B27 plays no role in determining the radiographic progression in AS.
评估 HLA-B27 纯合子对强直性脊柱炎（AS）放射学损害的影响。
本研究纳入了来自韩国脊柱关节病观察研究（OSKAR）队列的 368 例 HLA-B27 阳性 AS 患者。在所有 AS 患者中，评估 HLA-B27 阳性患者是否存在 HLA-B27 纯合子或杂合子。首先，根据 HLA-B27 阳性的携带状态对所有数据进行分层，进行横断面调查。然后比较各组之间的放射学损害评分。其次，我们评估了两组在两个不同时间点的临床和放射学参数。然后比较各组之间的放射学进展。使用 mSASSS，由两位有经验的骨骼关节放射科医生（S. Lee、K.B. Joo）检查颈椎和腰椎的 X 光片。
两位读者对 mSASSS 的一致性非常好：ICC 系数 0.70（95%置信区间 0.60-0.81）。AS 患者的平均年龄（标准差）为 37.0（9.2）岁，平均病程（标准差）为 15.6（9.1）年。在这些患者中，34.5%（127 例）存在 HLA-B27 纯合子。横断面调查中，两组的 mSASSS 单位（SEM）平均值无显著差异（纯合子 28.57±4.12，杂合子 23.34±3.44，P=0.344）。当考虑两组在 5 年内的放射学进展时，尽管调整了混杂因素，但两组之间没有显著差异（纯合子 4.98±0.98，杂合子 4.21±0.82，P=0.562）。
HLA-B27 阳性的携带状态对 AS 的放射学进展没有影响。
