血清碱性磷酸酶水平升高与轴性脊柱关节炎患者疾病活动度高和骨密度低相关。
Increased serum alkaline phosphatase levels correlate with high disease activity and low bone mineral density in patients with axial spondyloarthritis.
机构信息
Department of Internal medicine, Seoul St. Mary׳s Hospital, College of Medicine, The Catholic University of Korea, #505, Banpo-Dong, Seocho-Gu, Seoul, South Korea; Department of Internal medicine, Incheon St. Mary׳s Hospital, The Catholic University of Korea, Incheon, South Korea.
Department of Internal medicine, Seoul St. Mary׳s Hospital, College of Medicine, The Catholic University of Korea, #505, Banpo-Dong, Seocho-Gu, Seoul, South Korea.
出版信息
Semin Arthritis Rheum. 2015 Oct;45(2):202-7. doi: 10.1016/j.semarthrit.2015.03.002. Epub 2015 Mar 25.
OBJECTIVES
Recent studies report an association between serum alkaline phosphatase (ALP) levels and inflammation. The present study examined the relationship between ALP and disease activity, bone mineral density (BMD), and radiological damage in axial spondyloarthritis (SpA).
METHODS
A total of 115 patients who fulfilled the ASAS axial SpA criteria were enrolled. Serum ALP, bone-specific ALP (BALP), serum cross-linked telopeptide of type-I collagen (sCTX), and inflammatory markers were measured. Clinical parameters, BMD, grade of sacroiliitis, and the modified Stoke AS Spinal Score (mSASSS) were also assessed. The Ankylosing Spondylitis Disease Activity Score (ASDAS) was also calculated. The associations between serum ALP, disease activity score, BMD, and radiologic damage were evaluated.
RESULTS
The mean serum ALP level was 77 ± 26 U/l. Serum ALP levels increased in 14 patients (13%). Serum ALP levels increased along with ASDAS-CRP after adjusting for age and sex (p = 0.004), and were significantly correlated with ASDAS-ESR and ASDAS-CRP (p = 0.001 and p < 0.001, respectively), negatively correlated with BMD in the lumbar spine and femoral neck (p = 0.003 and 0.046, respectively), and positively correlated with sacroiliitis grade and the mSASSS (p < 0.001 and p < 0.002, respectively). BALP and sCTX were not associated with disease activity or BMD. Multivariate analysis showed that serum ALP was independently associated with ASDAS-CRP (p = 0.010).
CONCLUSIONS
Increased serum ALP levels were associated with high disease activity, low BMD, and higher structural damage scores in SpA patients.
目的
最近的研究报告显示血清碱性磷酸酶（ALP）水平与炎症之间存在关联。本研究旨在探讨血清 ALP 与轴性脊柱关节炎（SpA）患者的疾病活动度、骨密度（BMD）和放射学损伤之间的关系。
方法
共纳入符合 ASAS 轴性 SpA 标准的 115 例患者。检测血清 ALP、骨特异性 ALP（BALP）、I 型胶原交联端肽（sCTX）和炎症标志物。还评估了临床参数、BMD、骶髂关节炎程度和改良 Stoke AS 脊柱评分（mSASSS）。计算了强直性脊柱炎疾病活动度评分（ASDAS）。评估了血清 ALP、疾病活动评分、BMD 和放射学损伤之间的相关性。
结果
血清 ALP 平均水平为 77±26 U/l。在调整年龄和性别后，14 例患者（13%）血清 ALP 水平升高。血清 ALP 水平随 ASDAS-CRP 而升高（p=0.004），与 ASDAS-ESR 和 ASDAS-CRP 显著相关（p=0.001 和 p<0.001），与腰椎和股骨颈 BMD 呈负相关（p=0.003 和 0.046），与骶髂关节炎程度和 mSASSS 呈正相关（p<0.001 和 p<0.002）。BALP 和 sCTX 与疾病活动度或 BMD 无关。多变量分析显示，血清 ALP 与 ASDAS-CRP 独立相关（p=0.010）。
结论
血清 ALP 水平升高与 SpA 患者的高疾病活动度、低 BMD 和更高的结构损伤评分相关。
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