Serum visfatin levels in patients with axial spondyloarthritis and their relationship to disease activity and spinal radiographic damage: a cross-sectional study
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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.
KeywordsAxial spondyloarthritis Visfatin Disease activity Radiographic damage
Ankylosing Spondylitis Disease Activity Score
Bath Ankylosing Spondylitis Disease Activity Index
Body mass index
Conventional synthetic disease-modifying anti-rheumatic drugs
Biological disease-modifying anti-rheumatic drugs
Enzyme-linked immunosorbent assay
Human leukocyte antigen
Magnetic resonance imaging
Modified Stoke Ankylosing Spondylitis Spine Score
Non-radiographic axial spondyloarthritis
Non-steroidal anti-inflammatory drugs
Pre-B cell colony-enhancing factor
Radiographic axial spondyloarthritis
This work was supported by the Ministry of Health of the Czech Republic project 17-33127A.
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
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.
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.
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