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The clinical usefulness of ESR, CRP, and disease duration in ankylosing spondylitis: the product of these acute-phase reactants and disease duration is associated with patient’s poor physical mobility

  • Short Communication - Observational Research
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Abstract

We evaluated the clinical usefulness of ESR, CRP, and disease duration in ankylosing spondylitis (AS) disease severity. There were 156 Chinese AS patients included in Taiwan. Patients completed the questionnaires, containing demographic data, disease activity (BASDAI), functional status (BASFI), and patient’s global assessment (BASG). Meanwhile, patient’s physical mobility (BASMI) and acute-phase reactants, including ESR and CRP levels were measured. Receiver operating characteristic (ROC) plot analysis was used to evaluate the performance of ESR, CRP, and disease duration in the AS patients. ESR mildly correlated with BASFI (r = 0.176, p = 0.028) and disease duration (r = 0.214, p = 0.008), and moderately correlated with BASMI (r = 0.427, p < 0.001). CRP moderately correlated with BASMI (r = 0.410, p < 0.001). By using ROC plot analysis, ESR, CRP, and disease duration showed the best and significant “area under the curve (AUC)”, in distinguishing the AS patients with poor physical mobility (BASMI ≥ 3.6, the Median) (AUC = 0.748, 0.751 and 0.738, respectively, all p < 0.001), as compared to BASDAI, BASFI, and BASG. ESR × disease duration (AUC = 0.801, p < 0.001) and CRP × disease duration (AUC = 0.821, p < 0.001) showed higher AUC values than ESR or CRP alone in indicating poor physical mobility. For detecting poor physical mobility (BASMI ≥ 3.6) in the AS patients: ESR × disease duration (≥60.0 mm/h × year): sensitivity = 72.7 % and specificity = 72.8 %; CRP × disease duration (≥8.3 mg/dl × year): sensitivity = 72.7 % and specificity = 74.6 %. ESR, CRP, and disease duration are particularly related to AS patient’s poor physical mobility. Combining the usefulness of acute-phase reactants and disease duration, the values of ESR × disease duration and CRP × disease duration demonstrate better association with poor physical mobility in AS patients.

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References

  1. Zochling J, Brandt J, Braun J (2005) The current concept of spondyloarthritis with special emphasis on undifferentiated spondyloarthritis. Rheumatology 44:1483–1491

    Article  CAS  PubMed  Google Scholar 

  2. Machado P, Landewé R, Braun J, Hermann KG, Baker D, van der Heijde D (2010) Both structural damage and inflammation of the spine contribute to impairment of spinal mobility in patients with ankylosing spondylitis. Ann Rheum Dis 69:1465–1470

    Article  PubMed  Google Scholar 

  3. Sheehan NJ, Slavin BM, Donovan MP, Mount JN, Mathews JA (1986) Lack of correlation between clinical disease activity and erythrocyte sedimentation rate, acute-phase proteins or protease inhibitors in ankylosing spondylitis. Br J Rheumatol 25:171–174

    Article  CAS  PubMed  Google Scholar 

  4. Ruof J, Stucki G (1999) Validity aspects of erythrocyte sedimentation rate and C-reactive protein in ankylosing spondylitis: a literature review. J Rheumatol 26:966–970

    CAS  PubMed  Google Scholar 

  5. Poddubnyy D, Haibel H, Listing J, Märker-Hermann E, Zeidler H, Braun J et al (2012) Baseline radiographic damage, elevated acute-phase reactants and cigarette smoking status predict radiographic progression in the spine in early axial spondyloarthritis. Arthritis Rheum 64:1388–1398

    Article  PubMed  Google Scholar 

  6. Chen HA, Chen CH, Liao HT, Lin YJ, Chen PC, Chen WS et al (2011) Factors associated with radiographic spinal involvement and hip involvement in ankylosing spondylitis. Semin Arthritis Rheum 40:552–558

    Article  PubMed  Google Scholar 

  7. Cansu DU, Calışır C, Savaş Yavaş U, Kaşifoğlu T, Korkmaz C (2011) Predictors of radiographic severity and functional disability in Turkish patients with ankylosing spondylitis. Clin Rheumatol 30:557–562

    Article  PubMed  Google Scholar 

  8. Van der Linden S, Valkenburg HA, Cats A (1984) Evaluation of diagnostic criteria for ankylosing spondylitis: a proposal for modification of the New York criteria. Arthritis Rheum 27:361–368

    Article  PubMed  Google Scholar 

  9. Garrett S, Jenkinson T, Lg Kennedy, Whitelock H, Gaisford P, Calin A (1994) A new approach to defining disease status in ankylosing spondylitis: the Bath Ankylosing Spondylitis Disease Activity Index. J Rheumatol 21:2286–2291

    CAS  PubMed  Google Scholar 

  10. Calin A, Garrett S, Whitelock H, Kennedy LG, O’Hea J, Mallorie P et al (1994) A new approach to defining functional ability in ankylosing spondylitis: the development of the Bath Ankylosing Spondylitis Functional Index. J Rheumatol 21:2281–2285

    CAS  PubMed  Google Scholar 

  11. Sd Jones, Steiner A, Sl Garrett, Calin A (1996) The bath ankylosing spondylitis patient global score (BAS-G). Br J Rheumatol 35:66–71

    Article  Google Scholar 

  12. Jenkinson TR, Mallorie PA, Whitelock HC, Kennedy LG, Garrett SL, Calin A (1994) Defining spinal mobility in ankylosing spondylitis (AS). The Bath AS Metrology Index. J Rheumatol 21:1694–1698

    CAS  PubMed  Google Scholar 

  13. Jones SD, Porter J, Garrett SL, Kennedy LG, Whitelock H, Calin A (1995) A new scoring system for the Bath Ankylosing Spondylitis Metrology Index (BASMI). J Rheumatol 22:1609

    CAS  PubMed  Google Scholar 

  14. Doran MF, Brophy S, MacKay K, Taylor G, Calin A (2003) Predictors of longterm outcome in ankylosing spondylitis. J Rheumatol 30:316–320

    PubMed  Google Scholar 

  15. Cornec D, Jousse-Joulin S, Pers JO, Marhadour T, Cochener B, Boisramé-Gastrin S et al (2013) Contribution of salivary gland ultrasonography to the diagnosis of Sjögren’s syndrome: toward new diagnostic criteria? Arthritis Rheum 65:216–225

    Article  PubMed  Google Scholar 

  16. Brunner HI, Mina R, Pilkington C, Beresford MW, Reiff A, Levy DM et al (2011) Preliminary criteria for global flares in childhood-onset systemic lupus erythematosus. Arthritis Care Res (Hoboken) 63:1213–1223

    Article  Google Scholar 

  17. Gossec L, Paternotte S, Maillefert JF, Combescure C, Conaghan PG, Davis AM et al (2011) The role of pain and functional impairment in the decision to recommend total joint replacement in hip and knee osteoarthritis: an international cross-sectional study of 1909 patients. Report of the OARSI-OMERACT Task Force on total joint replacement. Osteoarthr Cartil 19:147–154

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  18. Cakar E, Taskaynatan MA, Dincer U, Kiralp MZ, Durmus O, Ozgül A (2009) Work disability in ankylosing spondylitis: differences among working and work-disabled patients. Clin Rheumatol 28:1309–1314

    Article  PubMed  Google Scholar 

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The authors have declared no conflicts of interests.

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Authors and Affiliations

  1. Division of Allergy, Immunology and Rheumatology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan

    Chun-Hsiung Chen & Chin-Hsiu Liu

  2. School of Medicine, Tzu Chi University, Hualien, Taiwan

    Chun-Hsiung Chen & Chin-Hsiu Liu

  3. Municipal Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan

    Chun-Hsiung Chen & Hsien-Tzung Liao

  4. Chi Mei Medical Center, Tainan, Taiwan

    Hung-An Chen

  5. National Yang-Ming University, Taipei, Taiwan

    Chang-Youh Tsai & Chung-Tei Chou

  6. Division of Allergy, Immunology and Rheumatology, Taipei Veterans General Hospital, No. 201, Section.2, ShiPai Road, Taipei, 112, Taiwan

    Chang-Youh Tsai & Chung-Tei Chou

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  1. Chun-Hsiung Chen
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  2. Hung-An Chen
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  3. Hsien-Tzung Liao
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  4. Chin-Hsiu Liu
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Correspondence to Chung-Tei Chou.

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Chen, CH., Chen, HA., Liao, HT. et al. The clinical usefulness of ESR, CRP, and disease duration in ankylosing spondylitis: the product of these acute-phase reactants and disease duration is associated with patient’s poor physical mobility. Rheumatol Int 35, 1263–1267 (2015). https://doi.org/10.1007/s00296-015-3214-4

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  • DOI: https://doi.org/10.1007/s00296-015-3214-4

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