Risk Factors for Spinal Structural Damage in a Chinese Cohort With Ankylosing Spondylitis

医学 强直性脊柱炎 体质指数 内科学 单变量分析 列线图 骶髂关节炎 射线照相术 脊柱炎 队列 外科 多元分析
作者
Weiping Kong,Caroline A. Jefferies,Thomas J. Learch,Xiaowei Gan,Feng Zhu,Nan Zhang,Dier Jin,Yingze Zhang,Qingwen Tao,Xiaoping Yan,Mariko Ishimori,Michael H. Weisman
出处
期刊:Jcr-journal of Clinical Rheumatology [Lippincott Williams & Wilkins]
卷期号:28 (1): e118-e124 被引量:4
标识
DOI:10.1097/rhu.0000000000001658
摘要

A cross-sectional study was conducted in 270 Chinese patients with ankylosing spondylitis (AS) in order to identify potential risk factors for severity of spinal structural damage.Two hundred seventy AS patients fulfilled the Modified New York Criteria. Computed tomography (CT) was used to scan sacroiliac and hip joints, and radiography was used to scan anteroposterior and lateral lumbar spine, as well as lateral cervical spine. Bath Ankylosing Spondylitis Radiology Index and modified Stoke Ankylosing Spondylitis Spine Score (mSASSS) were scored in duplicate.One hundred eighty-three patients had low mSASSS (mSASSS, <10), and 87 patients had high mSASSS (mSASSS, ≥10). Univariate analysis revealed that AS age of onset, body mass index (BMI), smoking duration, duration of symptoms, diagnostic delay, hip involvement, and sacroiliitis grade were significantly associated with the risk of having high mSASSS after adjustment (all p's < 0.05). Hip involvement interacted significantly with BMI and smoking duration in a graded manner. Particularly, relative to patients with low BMI-negative hip involvement, those with high BMI-negative hip involvement, low BMI-positive hip involvement, and high BMI-positive hip involvement had a 1.94-fold, 3.29-fold, and 5.07-fold increased risk of high mSASSS (95% confidence interval, 0.84-4.47, 1.37-7.89, and 1.97-13.06, p = 0.118, 0.008, and 0.001, respectively). Finally, a nomogram graph based on 7 significant risk factors was generated with substantial prediction accuracy (concordance index, 0.906).We have identified 7 potential risk factors for the severity of spinal structural damage in Chinese AS patients. Importantly, positive hip involvement, combined with high BMI or long smoking duration, was associated with a remarkably increased risk of having severe spinal structural damage.
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