Risk factors of ankylosing spondylitis with premature coronary heart disease / 中华风湿病学杂志

Objective:To analyze the risk factors of patients with ankylosing spondylitis (AS) combined with premature coronary atherosclerotic heart disease (PCAD).Methods:A total of 74 patients with AS and coronary atherosclerotic heart disease (CAD) in Peking Union Medical College Hospital from January 1983 to July 2021 were enrolled. According to the age of onset of coronary heart disease, the 74 patients were divided into PCAD group and NPCAD (non-premature coronary heart disease) group. T test and Chi square test were used to analyze the data of the two groups, the risk factors for AS-PCAD were analyzed by multivariate Logistic regression. Results:① There were 37 cases in the PCAD group and 37 cases in the NPCAD group. In the PCAD group, there were 28 men and 9 women; wherease all were men in the NPCAD group. The difference was statistically significant ( χ2=10.25, P=0.001). ② Compared with the NPCAD group, the age of AS-PCAD group was younger [(23±10) years vs (29±12) years, t=-2.28, P=0.026], and the course from AS to CAD was shorter [(25±10) years vs (34±13) years, t=-3.00, P=0.004], hemoglobin (Hb) level was lower [(122±23) g/L vs(132±18) g/L, t=2.10, P=0.039], rate of anemia was higher [38.5%(14/37) vs 16.2%(6/37), χ2=4.39, P=0.037]. Proportion of increased C-reactive protein (CRP) was higher [65.5%(19/29) vs 35.5%(11/31), χ2=5.41, P=0.019]. ③ Juvenile onset AS (JoAS)[ OR(95% CI)=3.45(1.31, 9.10), P=0.012] and high levels of CRP [ OR (95% CI)=3.68 (1.44, 9.40), P=0.006] might berisk factors of AS-PCAD by multiple logisctic regression analysis. Conclusion:Patients with AS have a higher probability of PCAD, especially in those patients with JoAS, persistent inflammation and anemia. It is necessary to be alert to the risk of PCAD and early screening.

Are Indian patients with juvenile-onset ankylosing spondylitis taller than reference population.

Background & objectives: Paucity of growth retardation has been observed by us in patients with juvenile-onset ankylosing spondylitis (JAS) in a tertiary care health centre in south India. We, therefore, undertook this pilot study to assess and compare anthropometry of patients with JAS who were 15 yr and older with that of adult onset ankylosing spondylitis (AAS) and matching Indian reference population. Methods: Consecutive male patients (December 2009- October 2012) with JAS and AAS fulfilling Modified New York Criteria were selected after applying inclusion and exclusion criteria. Demography and anthropometry were noted. Height of both patient groups as well as their parents and siblings were compared with that of the reference population. Mid-parental height and delta height were derived. Those with delta height of >8.5 cm were compared with the remaining. Multivariate logistic regression was done for variables that were found to be significant by chi-square in bivariate analysis. Similar analysis was done for BMI also. Results: There was no significant difference in anthropometric variables between JAS and AAS groups. Twenty eight of the 30 (93.33%) JAS patients were taller as compared to the reference population. Twenty six (86.67%) AAS patients were taller than the reference population. The mean heights of JAS (170.67 ± 6.94 cm) and AAS (168.2 ± 5.94 cm) patients were significantly higher than the reference value of 163.11 cm; both p<0.001. Logistic regression revealed that tallness in JAS was associated positively with hypermobility (OR=23.46,95%CI 1.2-447.2, p=0.036). No significant association was detected for height in AAS and for BMI in both JAS and AAS groups. Interpretation & conclusions: No growth retardation was seen in patients with JAS in our study. Majority of patients with JAS and AAS were taller than reference population. The difference between mean height of JAS and AAS was not significant. Larger studies involving different populations are required to confirm these findings.

A Case of Takayasu Arteritis in a Patient with Juvenile Onset Ankylosing Spondylitis / 대한류마티스학회지

Juvenile onset ankylosing spondylitis is a chronic inflammatory arthritis showing oligoarthritis and enthesopathy of the peripheral and axial skeleton. This have been shown to have different clinical presentation and outcome from adult onset ankylosing spondylitis. Takayasu arteritis is a uncommon, chronic inflammatory disease of elastic arteries such as the aorta, its larger branches and the pulmonary artery trunk. Although, it has rare report about association between ankylosing spondylitis and Takayasu arteritis, there was no report of juvenile onset ankylosing spondylitis with Takayasu arteritis. Thereby, we report a patient with Takayasu arteritis who had juvenile onset ankylosing spondylitis in the course of his disease.

Is Juvenile Onset Ankylosing Spondylitis Different from Adult Onset Ankylosing Spondylitis? / 대한류마티스학회지

OBJECTIVE: Ankylosing spondylitis is a well known form of spondyloarthropathy. It is recognized that age at onset is factor that may influence both the clinical presentation and course of disease. The pattern of symptoms in juvenile onset ankylosing spondylitis (JAS) differs significantly from that of adult onset (AS). METHODS: We investigated retrospectively the clinical characteristics of Korean JAS and AS. We reviewed two hundred and forty-two patients who had met the Modified New York criteria for AS. RESULTS: The JAS:AS ratio in the total AS patients was 88:154. The age of onset was 12.9+/-.67 (mean+/-D) in JAS and 22.6+/-.35 in AS. The sex ratio (M:F 81:7 in JAS, M:F 127:27 in AS) and disease duration (9.7+/-.7 in JAS, 801+/-.8 in AS) were similar in both groups. The most common site of initial symptom was knee in both groups, more frequent in JAS than in AS (JAS: 38%, AS: 25%, p<0.05). The peripheral arthritis was more frequent than axial symptom in initial symptom of both groups (JAS: 84%, AS:65%, p<0.01). There were significant differences in knee arthritis (JAS: 83%, AS:67%, P<0.001), ankle arthritis (JAS: 63%, AS: 39%, p<0.001), and tarsus involvement (JAS: 32%, AS: 19% P<0.05). The peripheral arthritis was found in 79%, more frequent in JAS than in AS (JAS: 90%, AS: 73%, p<0.001),. The arthritis in lower extremities was more frequent in JAS than in AS (JAS: 90%, AS: 72%, p<0.001). There were no differences in laboratory findings, spine involvement, and extraarticular symptoms including renal involvement, uveitis, and enthesitis (JAS: 86%, AS: 81%) between both groups. CONCLUSIONS: Contrary to foreign reports, the peripheral arthritis was more common, sex ratio of male versus female was higher among JAS in Korea. The peripheral arthritis in JAS is more frequent than in AS, and main symptoms in JAS was found more common in peripheral than in axial joints. There were significant differences on initial symptom site and peripheral arthritis of lower extremity, especially knee, ankle and tarsus in both group.