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低水平血清尿酸会增加年轻男性强直性脊柱炎患者骨密度低的风险。

Low levels of serum uric Acid increase the risk of low bone mineral density in young male patients with ankylosing spondylitis.

作者信息

Kang Kwi Young, Hong Yeon Sik, Park Sung-Hwan, Ju Ji Hyeon

机构信息

From the Division of Rheumatology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul; and the Division of Rheumatology, Department of Internal Medicine, College of Medicine, Incheon Saint Mary's Hospital, Incheon, South Korea.K.Y. Kang, MD, PhD; Y.S. Hong, MD, PhD, Division of Rheumatology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, and Division of Rheumatology, Department of Internal Medicine, College of Medicine, Incheon Saint Mary's Hospital; S.H. Park, MD, PhD; J.H. Ju, MD, PhD, Division of Rheumatology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea.

出版信息

J Rheumatol. 2015 Jun;42(6):968-74. doi: 10.3899/jrheum.140850. Epub 2015 Apr 1.

Abstract

OBJECTIVE

Uric acid (UA) has antiosteoporotic effects in postmenopausal women. This study investigated the association between serum UA levels and bone mineral density (BMD) in young male patients with ankylosing spondylitis (AS).

METHODS

One hundred fifty patients who fulfilled the modified New York criteria for the classification of AS were analyzed. All patients were male and under 50 years of age. BMD, serum UA concentrations, clinical variables, and radiographic progression were assessed. The associations between UA and BMD at the lumbar spine and hip were evaluated using multiple linear regression analysis. Multivariate logistic regression analyses were performed to identify risk factors associated with low BMD.

RESULTS

Mean serum UA concentration in the 150 patients with AS was 5.5 ± 1.3 mg/dl. BMD at the lumbar spine, but not at the total hip and femoral neck, increased with increasing serum UA tertiles (p = 0.033). The significant positive association between serum UA and BMD at the lumbar spine remained after adjustment for confounding factors (β = 0.185, p = 0.014, adjusted R(2) = 0.310). Multiple logistic regression analyses showed that lower UA concentrations (OR 4.02, 95% CI 1.34-12.3) and body mass index and increased erythrocyte sedimentation rate were independently associated with the risk of low BMD.

CONCLUSION

Lower serum UA levels are associated with lower BMD in young male patients with AS. UA may be a novel predictive marker or therapeutic target in patients with AS.

摘要

目的

尿酸(UA)对绝经后女性具有抗骨质疏松作用。本研究调查了年轻男性强直性脊柱炎(AS)患者血清尿酸水平与骨密度(BMD)之间的关联。

方法

分析了150例符合AS改良纽约分类标准的患者。所有患者均为男性,年龄在50岁以下。评估了骨密度、血清尿酸浓度、临床变量和影像学进展情况。采用多元线性回归分析评估尿酸与腰椎和髋部骨密度之间的关联。进行多因素逻辑回归分析以确定与低骨密度相关的危险因素。

结果

150例AS患者的平均血清尿酸浓度为5.5±1.3mg/dl。随着血清尿酸三分位数的增加,腰椎骨密度增加,但全髋和股骨颈骨密度未增加(p = )。在调整混杂因素后,血清尿酸与腰椎骨密度之间仍存在显著正相关(β = ,p = ,调整后R² = )。多因素逻辑回归分析显示,较低的尿酸浓度(OR ,95%CI )、体重指数和红细胞沉降率增加与低骨密度风险独立相关。

结论

年轻男性AS患者血清尿酸水平较低与骨密度较低有关。尿酸可能是AS患者的一种新的预测标志物或治疗靶点。

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