Division of Rheumatology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea , Seoul, Republic of Korea.
Division of Rheumatology, Department of Internal Medicine, Incheon Saint Mary's Hospital, College of Medicine, The Catholic University of Korea , Incheon, Republic of Korea.
Scand J Rheumatol. 2020 Sep;49(5):397-404. doi: 10.1080/03009742.2020.1748707. Epub 2020 Jul 13.
: To compare faecal calprotectin levels according to the type of manifestation and to investigate factors associated with increases in faecal calprotectin in patients with axial spondyloarthritis (axSpA). : The study enrolled 190 patients fulfilling the imaging arm of the Assessment of SpondyloArthritis international Society axSpA criteria. Faecal calprotectin levels were measured in an enzyme-linked immunosorbent assay. Systemic inflammatory markers and the Ankylosing Spondylitis Disease Activity Score (ASDAS) were also assessed. Peripheral joint involvement was assessed using the 44-joint examination and Spondyloarthritis Research Consortium of Canada Enthesitis Index. : Of 190 patients, 34 (18%) had increased faecal calprotectin levels. These patients were more likely to have ongoing peripheral arthritis and enthesitis (p = 0.016 and 0.001, respectively). A history of psoriasis and uveitis, or current uveitis symptoms, had no bearing on faecal calprotectin levels. Faecal calprotectin levels increased along with ASDAS-C-reactive protein (CRP), and correlated with ASDAS-erythrocyte sedimentation rate (ESR) (r = 0.240, p = 0.001), ASDAS-CRP (r = 0.162, p = 0.025), ESR (r = 0.228, p = 0.002), and CRP levels (0.258, p < 0.001). Tender joint and swollen joint counts also correlated with faecal calprotectin levels (r = 0.252 and 0.205, p < 0.001 and p = 0.005, respectively). Faecal calprotectin levels were higher in patients with current peripheral symptoms (p = 0.003). Peripheral symptoms were independently associated with increased faecal calprotectin levels (odds ratio = 4.083; 95% confidence interval 1.580-10.556). : Faecal calprotectin levels in axSpA patients were associated with disease activity. Subclinical gut inflammation (assessed by measuring faecal calprotectin) in axSpA is more closely related to peripheral joint inflammation than to axial joint inflammation.
比较粪便钙卫蛋白水平根据表现的类型，并探讨与粪便钙卫蛋白增加相关的因素在中轴型脊柱关节炎（axSpA）患者。该研究纳入了 190 名符合影像学 axSpA 国际协会标准的患者。采用酶联免疫吸附试验测定粪便钙卫蛋白水平。还评估了全身炎症标志物和强直性脊柱炎疾病活动评分（ASDAS）。使用 44 关节检查和加拿大脊柱关节炎研究协会附着点炎指数评估外周关节受累。在 190 名患者中，34 名（18%）粪便钙卫蛋白水平升高。这些患者更有可能持续存在外周关节炎和附着点炎（p=0.016 和 0.001）。银屑病和葡萄膜炎病史或当前葡萄膜炎症状与粪便钙卫蛋白水平无关。粪便钙卫蛋白水平随着 ASDAS-C 反应蛋白（CRP）的增加而增加，并与 ASDAS-红细胞沉降率（ESR）相关（r=0.240，p=0.001），ASDAS-CRP（r=0.162，p=0.025），ESR（r=0.228，p=0.002）和 CRP 水平（0.258，p<0.001）。触诊关节和肿胀关节计数也与粪便钙卫蛋白水平相关（r=0.252 和 0.205，p<0.001 和 p=0.005）。当前外周症状患者的粪便钙卫蛋白水平更高（p=0.003）。外周症状与粪便钙卫蛋白水平升高独立相关（优势比=4.083；95%置信区间 1.580-10.556）。axSpA 患者的粪便钙卫蛋白水平与疾病活动相关。中轴型脊柱关节炎患者的亚临床肠道炎症（通过测量粪便钙卫蛋白评估）与外周关节炎症的关系比与中轴关节炎症的关系更密切。
