Sandhya Pulukool, Danda Debashish, Jeyaseelan Lakshmanan
Department of Rheumatology & Clinical Immunology, Christian Medical College & Hospital, Vellore, India.
Indian J Med Res. 2015 Apr;141(4):446-53. doi: 10.4103/0971-5916.159295.
BACKGROUND & OBJECTIVES: Paucity of growth retardation has been observed by us in patients with juvenile-onset ankylosing spondylitis (JAS) in a tertiary care health centre in south India. We, therefore, undertook this pilot study to assess and compare anthropometry of patients with JAS who were 15 yr and older with that of adult onset ankylosing spondylitis (AAS) and matching Indian reference population.
Consecutive male patients (December 2009- October 2012) with JAS and AAS fulfilling Modified New York Criteria were selected after applying inclusion and exclusion criteria. Demography and anthropometry were noted. Height of both patient groups as well as their parents and siblings were compared with that of the reference population. Mid-parental height and delta height were derived. Those with delta height of >8.5 cm were compared with the remaining. Multivariate logistic regression was done for variables that were found to be significant by chi-square in bivariate analysis. Similar analysis was done for BMI also.
There was no significant difference in anthropometric variables between JAS and AAS groups. Twenty eight of the 30 (93.33%) JAS patients were taller as compared to the reference population. Twenty six (86.67%) AAS patients were taller than the reference population. The mean heights of JAS (170.67 ± 6.94 cm) and AAS (168.2 ± 5.94 cm) patients were significantly higher than the reference value of 163.11 cm; both p0 <0.001. Logistic regression revealed that tallness in JAS was associated positively with hypermobility (OR=23.46,95%CI 1.2-447.2, p0 =0.036). No significant association was detected for height in AAS and for BMI in both JAS and AAS groups.
INTERPRETATION & CONCLUSIONS: No growth retardation was seen in patients with JAS in our study. Majority of patients with JAS and AAS were taller than reference population. The difference between mean height of JAS and AAS was not significant. Larger studies involving different populations are required to confirm these findings.
在印度南部一家三级医疗保健中心，我们观察到青少年型强直性脊柱炎（JAS）患者生长发育迟缓的情况较少。因此，我们开展了这项初步研究，以评估和比较15岁及以上的JAS患者与成人型强直性脊柱炎（AAS）患者以及相匹配的印度参考人群的人体测量学指标。
在应用纳入和排除标准后，选取了符合改良纽约标准的连续男性JAS和AAS患者（2009年12月至2012年10月）。记录人口统计学和人体测量学数据。将两组患者及其父母和兄弟姐妹的身高与参考人群的身高进行比较。计算父母平均身高和身高差值。身高差值>8.5 cm的患者与其余患者进行比较。对双变量分析中经卡方检验发现有显著意义的变量进行多因素逻辑回归分析。对BMI也进行了类似分析。
JAS组和AAS组的人体测量学变量无显著差异。30例JAS患者中有28例（93.33%）比参考人群高。26例（86.67%）AAS患者比参考人群高。JAS患者（170.67±6.94 cm）和AAS患者（168.2±5.94 cm）的平均身高显著高于参考值163.11 cm；两者p<0.001。逻辑回归显示，JAS患者的高身材与关节活动过度呈正相关（OR=23.46，95%CI 1.2-447.2，p=0.036）。AAS患者的身高以及JAS和AAS两组患者的BMI均未检测到显著相关性。
在我们的研究中，JAS患者未见生长发育迟缓。大多数JAS和AAS患者比参考人群高。JAS和AAS患者的平均身高差异不显著。需要开展涉及不同人群的更大规模研究来证实这些发现。
