Department of Rheumatology, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China.
Department of Orthopaedic Trauma and Joint Surgery, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China.
Mod Rheumatol. 2022 Jul 1;32(4):770-775. doi: 10.1093/mr/roab044.
To identify disease activity scores and biomarkers that reflect magnetic resonance imaging (MRI)-determined sacroiliac joint (SIJ) inflammation in ankylosing spondylitis (AS) and non-radiographic axial spondyloarthritis (nr-axSpA).
Patients who had AS and nr-axSpA were enrolled. All the patients underwent SIJ MRI. SpondyloArthritis Research Consortium of Canada (SPARCC) method was used to score bone marrow edema in the inflammatory lesions on MRI. Radiographic assessment of the spine was performed using modified Stoke Ankylosing Spondylitis Spine Score. Clinical variables, inflammatory markers, serum alkaline phosphatase, osteocalcin (OC), C-terminal telopeptide of type I collagen (CTX-I), and procollagen I N-terminal peptide (PINP) were measured. Correlation analysis between MRI-determined SIJ inflammation scores and disease activity scores and laboratory variables was performed.
Thirty-five patients had AS and 36had nr-axSpA. Significant differences were noted between the AS group and the nr-axSpA group in terms of erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), Ankylosing Spondylitis Disease Activity Score (ASDAS)-ESR, ASDAS-CRP, PINP, and SPARCC (p < .001, p = .004, p < .001, p < .001, p = .030, p < .001, respectively). MRI-determined SIJ inflammatory scores correlated with Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), OC, CTX-I, and PINP in AS (p = .036, p = .023, p = .002, p = .041, p = .004, respectively) and correlated with ESR, CRP, ASDAS-ESR, ASDAS-CRP, BASDAI, and BASFI in nr-axSpA (p = .003, p = .002, p < .001, p < .001, p = .010, p = .007, respectively). Multivariate analysis showed that PINP exhibited a positive correlation independent of the MRI inflammatory score and that age exhibited a negative correlation independent of the MRI inflammatory score.
In AS, PINP and age independently correlated with active inflammation on SIJ MRI. PINP may be useful as a marker of objective inflammation in AS.
确定反映强直性脊柱炎（AS）和非放射学中轴型脊柱关节炎（nr-axSpA）骶髂关节（SIJ）炎症的疾病活动评分和生物标志物。
纳入患有 AS 和 nr-axSpA 的患者。所有患者均接受 SIJ MRI 检查。采用 SpondyloArthritis Research Consortium of Canada（SPARCC）方法对 MRI 上炎症性病变中的骨髓水肿进行评分。使用改良 Stoke 强直性脊柱炎脊柱评分对脊柱进行放射学评估。测量临床变量、炎症标志物、血清碱性磷酸酶、骨钙素（OC）、I 型胶原 C 端肽（CTX-I）和前胶原 I N 端肽（PINP）。对 MRI 确定的 SIJ 炎症评分与疾病活动评分和实验室变量之间的相关性进行分析。
35 例患者患有 AS，36 例患者患有 nr-axSpA。AS 组与 nr-axSpA 组在红细胞沉降率（ESR）、C 反应蛋白（CRP）、强直性脊柱炎疾病活动评分（ASDAS-ESR）、ASDAS-CRP、PINP 和 SPARCC 方面存在显著差异（p<0.001，p=0.004，p<0.001，p<0.001，p=0.030，p<0.001）。AS 中，MRI 确定的 SIJ 炎症评分与 Bath 强直性脊柱炎疾病活动指数（BASDAI）、Bath 强直性脊柱炎功能指数（BASFI）、OC、CTX-I 和 PINP 相关（p=0.036，p=0.023，p=0.002，p=0.041，p=0.004），与 ESR、CRP、ASDAS-ESR、ASDAS-CRP、BASDAI 和 BASFI 相关（p=0.003，p=0.002，p<0.001，p<0.001，p=0.010，p=0.007）。多变量分析显示，PINP 与 MRI 炎症评分呈正相关，而年龄与 MRI 炎症评分呈负相关，且均不受其他因素影响。
在 AS 中，PINP 和年龄与 SIJ MRI 上的活动性炎症独立相关。PINP 可能是 AS 中一种有用的客观炎症标志物。
