Almodóvar Raquel, Ríos Valeria, Ocaña Sara, Gobbo Milena, Casas María-Luisa, Zarco-Montejo Pedro, Juanola Xavier
Rheumatology Unit, Hospital Universitario Fundación Alcorcón, Avda. Budapest s/n, 28922, Alcorcón, Madrid, Spain,
Clin Rheumatol. 2014 Feb;33(2):237-41. doi: 10.1007/s10067-013-2349-5. Epub 2013 Aug 7.
To assess the association between biomarkers of inflammation, cartilage and bone turnover with gender, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Spondylitis Disease Activity Score (ASDAS) and bone marrow oedema in resonance magnetic imaging (MRI) of sacroiliac joints (SIJs) and radiological damage in early spondyloarthritis (SpA). Cross-sectional study of 60 patients (56.7 % females; mean age, 32.4 years) with early SpA. Sociodemographic data, clinical features, serum matrix metalloproteinase 3 (MMP-3), high sensitivity C-reactive protein (hsCRP), C-terminal cross-linking telopeptides of type I collagen (CTX-I) and urinary deoxypyridinoline, ASDAS, BASDAI, BASFI, BASRI and MRI of the SIJs were collected. The mean (SD) disease duration was 12.4 (6.8 months). Twenty-two (68.7 %) of the 32 patients had active sacroiliitis by MRI. MMP-3 and CTX I correlated with swollen joint (r = 0.515, r = 0.386, p = 0.01). hsCRP correlated with ESR (r = 0.303, p = 0.05), with CRP (r = 0.455, p = 0.01) and with total BASRI (r = 0.95, p = 0.05). Biomarkers were unrelated with the rest of variables. Levels of MMP-3 (44.3 ± 52.4 vs 24.7 ± 33.4, p < 0.05) and CTX-I (0.53 ± 0.45 vs 0.24 ± 0.38; p < 0.05) were higher in men. Our study shows that CTX-I and MMP-3 are a marker of peripheral disease activity in early SpA. Male gender had higher levels of CTX-I and MMP-3, which may indicate higher disease activity. Higher hsCRP levels trended towards correlation with more baseline radiographic damage. Therefore, these biomarkers may help identify a subgroup of patients who will need closer monitoring and more intensive treatment.
评估炎症、软骨和骨转换生物标志物与性别、巴斯强直性脊柱炎疾病活动指数（BASDAI）、脊柱炎疾病活动评分（ASDAS）以及骶髂关节（SIJ）磁共振成像（MRI）中的骨髓水肿和早期脊柱关节炎（SpA）放射学损伤之间的关联。对60例早期SpA患者（56.7%为女性；平均年龄32.4岁）进行横断面研究。收集社会人口学数据、临床特征、血清基质金属蛋白酶3（MMP - 3）、高敏C反应蛋白（hsCRP）、I型胶原C末端交联端肽（CTX - I）和尿脱氧吡啶啉、ASDAS、BASDAI、BASFI、BASRI以及SIJ的MRI数据。平均（标准差）病程为12.4（6.8个月）。32例患者中有22例（68.7%）通过MRI显示有活动性骶髂关节炎。MMP - 3和CTX I与关节肿胀相关（r = 0.515，r = 0.386，p = 0.01）。hsCRP与血沉（r = 0.303，p = 0.05）、CRP（r = 0.455，p = 0.01）以及总BASRI相关（r = 0.95，p = 0.05）。生物标志物与其他变量无关。男性的MMP - 3（44.3±52.4 vs 24.7±33.4，p < 0.05）和CTX - I水平（0.53±0.45 vs 0.24±0.38；p < 0.05）更高。我们的研究表明，CTX - I和MMP - 3是早期SpA外周疾病活动的标志物。男性的CTX - I和MMP - 3水平更高，这可能表明疾病活动度更高。更高的hsCRP水平倾向于与更多的基线放射学损伤相关。因此，这些生物标志物可能有助于识别出需要更密切监测和更强化治疗的患者亚组。
