Rheumatology International

, Volume 39, Issue 6, pp 1037–1043 | Cite as

Serum visfatin levels in patients with axial spondyloarthritis and their relationship to disease activity and spinal radiographic damage: a cross-sectional study

  • Hana HulejováEmail author
  • Tereza Kropáčková
  • Kristýna Bubová
  • Olga Kryštůfková
  • Mária Filková
  • Heřman Mann
  • Šárka Forejtová
  • Michal Tomčík
  • Jiří Vencovský
  • Karel Pavelka
  • Ladislav Šenolt
Observational Research


The purpose of this cross-sectional study was to assess the visfatin levels in patients with axial spondyloarthritis (axSpA) and to investigate the association between visfatin, disease activity and radiographic spinal damage. Serum visfatin levels were determined by enzyme-linked immunosorbent assay in 64 patients with axSpA (46 with radiographic axSpA (r-axSpA) and 18 with non-radiographic axSpA (nr-axSpA)) and 61 age-/sex-matched healthy individuals. Patients with r-axSpA were further divided into two subsets based on radiographic spinal damage using modified Stoke Ankylosing Spondylitis Spine Score (mSASSS = 0 and mSASSS ≥ 1). The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) was used to assess disease activity. C-reactive protein (CRP) levels and human leukocyte antigen (HLA)-B27 were determined. Visfatin levels were significantly higher in patients with axSpA and in the subgroup of patients with r-axSpA than in healthy individuals (p = 0.010 and p = 0.005, respectively), with no difference between patients with r-axSpA and with nr-axSpA. In general, disease activity was high (mean BASDAI 5.01) and was moderately correlated with visfatin levels (r = 0.585; p = 0.011) in patients with nr-axSpA. Visfatin levels correlated with mSASSS (r = 0.281; p = 0.026) and were significantly higher in axSpA patients with mSASSS ≥ 1 than in those with mSASSS = 0 (p = 0.025). Our study showed that circulating visfatin levels are elevated in axSpA patients, may be associated with disease activity in early phase of the disease and with the degree of radiographic spinal involvement.


Axial spondyloarthritis Visfatin Disease activity Radiographic damage 



Ankylosing Spondylitis Disease Activity Score


Axial spondyloarthritis


Bath Ankylosing Spondylitis Disease Activity Index


Body mass index


Conventional synthetic disease-modifying anti-rheumatic drugs


Biological disease-modifying anti-rheumatic drugs


C-reactive protein


Enzyme-linked immunosorbent assay


Human leukocyte antigen


Interquartile range


Magnetic resonance imaging


Modified Stoke Ankylosing Spondylitis Spine Score


Nicotinamide phosphoribosyltransferase


Non-radiographic axial spondyloarthritis


Non-steroidal anti-inflammatory drugs


Pre-B cell colony-enhancing factor


Radiographic axial spondyloarthritis


Sacroiliac joints



This work was supported by the Ministry of Health of the Czech Republic project 17-33127A.

Author contributions

LŠ and JV were responsible for the study concept and design. HH performed ELISA tests. KB, MF, HM, ŠF, JV and LŠ were involved in enrolling the patients and made clinical assessments. HH, TL and OK carried out the statistical analysis. HH, TL and LŠ were responsible for data interpretation and manuscript preparation. MT, JV, KP and LŠ revised the manuscript critically for important intellectual content. All authors read and approved the final version of the manuscript.

Compliance with ethical standards

Ethical approval

All procedures performed in this study involving human participants were in accordance with the ethical standard of the local ethics committee of the Institute of Rheumatology in Prague, Czech Republic.

Informed consent

Written informed consent was obtained from all participants.

Conflict of interest

Hana Hulejová declares that she does not have competing interests. Tereza Kropáčková declares that she does not have competing interests. Kristýna Bubová declares that she does not have competing interests. Olga Kryštůfková declares that she does not have competing interests. Mária Filková declares that she does not have competing interests. Šárka Forejtová declares that she does not have competing interests. Heřman Mann declares that he does not have competing interests. Michal Tomčík declares that he does not have competing interests. Jiří Vencovský declares that he does not have competing interests. Karel Pavelka declares that he does not have competing interests. Ladislav Šenolt declares that he does not have competing interests.

Supplementary material

296_2019_4301_MOESM1_ESM.docx (179 kb)
Supplementary material 1 (DOCX 179 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Institute of RheumatologyPrague 2Czech Republic
  2. 2.Department of Rheumatology, First Faculty of MedicineCharles UniversityPragueCzech Republic

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