Non-hepatic alkaline phosphatase, hs-CRP and progression of vertebral fracture in patients with rheumatoid arthritis: A population-based longitudinal study
Journal
Journal of Clinical Medicine
Journal Volume
7
Journal Issue
11
Date Issued
2018-11-13
Author(s)
Yeh, Jih-Chen
Wu, Chang-Chin
Choy, Cheuk-Sing
Liou, Jian-Chiun
Chen, Kuo-Shu
Tung, Tao-Hsin
Lin, Wei-Ning
Hsieh, Chih-Yu
Ho, Chun-Ta
Chang, Jia-Feng
Abstract
Background: Interactions and early warning effects of non-hepatic alkaline phosphatase (NHALP) and high-sensitivity C-reactive protein (hs-CRP) on the progression of vertebral fractures (VFs) in patients with rheumatoid arthritis (RA) remain unclear. We aim to explore whether serum concentrations of NHALP and hs-CRP could serve as a promising dual biomarker for prognostic assessment of VF progression. Methods: Unadjusted and adjusted hazard ratios (aHRs) of VF progression were calculated for different categories of serum NHALP and hs-CRP using the Cox regression model in RA patients. The modification effect between serum NHALP and hs-CRP on VF progression was determined using an interaction product term. Results: During 4489 person-years of follow-up, higher NHALP (>125 U/L) and hs-CRP (>3.0 mg/L) were robustly associated with incremental risks of VF progression in RA patients (aHR: 2.2 (95% confidence intervals (CIs): 1.2–3.9) and 2.0 (95% CI: 1.3–3.3) compared to the lowest HR category, respectively). The interaction between NHALP and hs-CRP on VF progression was statistically significant (p < 0.05). In the stratified analysis, patients with combined highest NHALP and hs-CRP had the greatest risk of VF progression (aHR: 4.9 (95% CI: 2.5–9.6)) compared to the lowest HR group (NHALP < 90 U/L and hs-CRP < 1 mg/L). Conclusions: In light of underdiagnoses of VFs and misleading diagnosis by single test, NHALP and hs-CRP could serve as compensatory biomarkers to predict subclinical VF progression in RA patients. © 2018 by the authors. Licensee MDPI, Basel, Switzerland.
Subjects
Alkaline phosphatase; C-reactive protein; Rheumatoid arthritis; Vertebral fractures
Other Subjects
alanine aminotransferase; albumin; alkaline phosphatase; C reactive protein; creatinine; hemoglobin; hemoglobin A1c; potassium; rheumatoid factor; sodium; triacylglycerol; uric acid; adult; Article; cohort analysis; computer assisted tomography; diabetes mellitus; disease exacerbation; erythrocyte sedimentation rate; estimated glomerular filtration rate; female; follow up; glucose blood level; human; hyperlipidemia; hypertension; leukocyte count; longitudinal study; major clinical study; male; middle aged; osteoporosis; radiography; retrospective study; rheumatoid arthritis; smoking; spine fracture; total cholesterol level; urea nitrogen blood level
Type
journal article