Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, South Korea.
Department of Statistics and Data Science, Korea National Open University, Seoul, South Korea.
Sci Rep. 2023 Jun 5;13(1):9093. doi: 10.1038/s41598-023-36340-9.
This retrospective study evaluated the electronic medical records of patients with ankylosing spondylitis (AS) (January 2001-December 2018) to determine the relationship between serum alkaline phosphatase (ALP) levels and radiographic changes over time. Longitudinal data, including serum ALP levels, were imputed by linear interpolation at 3-month intervals. Among the serum ALP levels calculated for 8 years prior to modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS) measurement, those having the highest beta coefficient with the mSASSS were selected in the correlation between ALP and longitudinal mSASSS. Linear mixed models with the selected serum ALP levels, mSASSS, and clinical variables were investigated. We included 1122 patients (mean follow-up, 8.20 [standard deviation: 2.85] years). The serum ALP level from 5 years and 3 months prior showed the highest beta coefficient with the mSASSS. In the linear mixed model, the serum ALP level at 5 years and 3 months before radiographic changes was significantly associated with the mSASSS (β = 0.021, 95% confidence interval: 0.017-0.025, p < 0.001). Serum ALP levels measured approximately 5 years before may be a surrogate marker for predicting spinal radiographic changes. Long-term prospective clinical and experimental studies of > 5 years are required for biomarker discovery or therapeutic research on AS radiographic progression.
本回顾性研究评估了强直性脊柱炎（AS）患者的电子病历（2001 年 1 月至 2018 年 12 月），以确定血清碱性磷酸酶（ALP）水平与随时间推移的影像学变化之间的关系。纵向数据（包括血清 ALP 水平）通过线性插值在每 3 个月间隔进行估算。在测量改良 Stoke 强直性脊柱炎脊柱评分（mSASSS）之前的 8 年内计算的血清 ALP 水平中，选择与 mSASSS 相关性最高的 beta 系数。用选定的血清 ALP 水平、mSASSS 和临床变量对线性混合模型进行了研究。我们纳入了 1122 名患者（平均随访时间为 8.20 [标准差：2.85] 年）。在 mSASSS 中，来自 5 年零 3 个月前的血清 ALP 水平显示出与 mSASSS 相关性最高的 beta 系数。在线性混合模型中，在影像学变化前 5 年和 3 个月的血清 ALP 水平与 mSASSS 显著相关（β=0.021，95%置信区间：0.017-0.025，p<0.001）。大约在 5 年前测量的血清 ALP 水平可能是预测脊柱影像学变化的替代标志物。需要进行超过 5 年的长期前瞻性临床和实验研究，以发现 AS 影像学进展的生物标志物或治疗研究。
