Clinical and immunogenetic prognostic factors for radiographic severity in ankylosing spondylitis.
Clinical and immunogenetic prognostic factors for radiographic severity in ankylosing spondylitis.
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DOI：
10.1002/art.24585
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发表时间：
2009-07-15
影响因子：
--
通讯作者：
Weisman, Michael H.
中科院分区：
文献类型：
--
作者：
Ward, Michael M.;Hendrey, Matthew R.;Malley, James D.;Learch, Thomas J.;Davis, John C., Jr.;Reveille, John D.;Weisman, Michael H.
为了提高强直性脊柱炎（AS）的预后能力，我们试图在一个大的患者队列中确定与影像学严重程度相关的人口统计学、临床和免疫遗传学特征。20岁或以上的AS患者入选了一项横断面研究（N=398）。使用Bath AS放射学指数-脊柱（BASRI-S）对骨盆和脊柱X线片进行评分，并以BASRI-S/AS持续时间测量放射学严重程度。临床因素和HLA-B，DR，DQ和DP等位基因与放射学严重程度分布的最高四分位数进行了鉴定，首先使用随机森林，然后多变量logistic回归模型。使用类似的程序来确定与放射学严重程度最低四分位数相关的因素。放射学严重度（处于BASRI-S/AS持续时间的前四分位数）与AS发病年龄较大相关（比值比（OR）1.10/年），男性（OR 1.90），目前吸烟（OR 4.72），并存在HLA- B*4100 DRB 1 *0804（OR 12.32）、DQA 1 *0401（OR 5.24）、DQB 1 *0603（OR 3.42）和DPB 1 *0202（OR 23.36），而DRB 1 *0801的存在强烈负相关（OR 0.03）。处于BASRI-S/AS持续时间最低四分位数的患者在AS发病年龄较大的患者（OR 0.94/年）、男性（OR 0.28）和当前吸烟者（OR 0.29）中的可能性也较小。通过了解发病年龄、性别、吸烟史以及HLA-B*4100、DRB 1 *0804、DQA 1 *0401、DQB 1 *0603、DRB 1 *0801和DPB 1 *0202等位基因的存在，可以提高AS放射学严重程度预后的准确性。
To improve prognostic ability in ankylosing spondylitis (AS), we sought to identify demographic, clinical, and immunogenetic characteristics associated with radiographic severity in a large cohort of patients. Patients with AS of 20 years or more were enrolled in a cross-sectional study (N=398). Pelvic and spinal radiographs were scored using the Bath AS Radiology Index-Spine (BASRI-S), and radiographic severity was measured as BASRI-S/duration of AS. Clinical factors and HLA-B, DR, DQ, and DP alleles associated with the highest quartile of the distribution of radiographic severity were identified by first using random forests and then multivariable logistic regression modeling. Similar procedures were used to identify factors associated with the lowest quartile of radiographic severity. Radiographic severity (being in the top quartile of BASRI-S/duration of AS) was associated with older age of onset of AS (odds ratio (OR) 1.10 per year), male gender (OR 1.90), current smoking (OR 4.72), and the presence of HLA- B*4100 (OR 11.73), DRB1*0804 (OR 12.32), DQA1*0401 (OR 5.24), DQB1*0603 (OR 3.42), and DPB1*0202 (OR 23.36), while the presence of DRB1*0801 was strongly negatively associated (OR 0.03). Being in the lowest quartile of BASRI-S/duration of AS was also less likely among those with an older age of onset of AS (OR 0.94 per year), men (OR 0.28), and current smokers (OR 0.29). The accuracy of prognosis of radiographic severity in AS is improved by knowing the age of onset, gender, smoking history, and the presence of HLA-B*4100, DRB1*0804, DQA1*0401, DQB1*0603, DRB1*0801, and DPB1*0202 alleles.
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影响因子：
27.4
作者：
Lee, Wonuk;Reveille, John D.;Weisman, Michael H.
通讯作者：
Weisman, Michael H.
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