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Non-Hepatic Alkaline Phosphatase, hs-CRP and Progression of Vertebral Fracture in Patients with Rheumatoid Arthritis: A Population-Based Longitudinal Study

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...

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Autores principales: Yeh, Jih-Chen, Wu, Chang-Chin, Choy, Cheuk-Sing, Chang, Shu-Wei, Liou, Jian-Chiun, Chen, Kuo-Shu, Tung, Tao-Hsin, Lin, Wei-Ning, Hsieh, Chih-Yu, Ho, Chun-Ta, Wang, Ting-Ming, Chang, Jia-Feng
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6262279/
https://www.ncbi.nlm.nih.gov/pubmed/30428612
http://dx.doi.org/10.3390/jcm7110439
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author Yeh, Jih-Chen
Wu, Chang-Chin
Choy, Cheuk-Sing
Chang, Shu-Wei
Liou, Jian-Chiun
Chen, Kuo-Shu
Tung, Tao-Hsin
Lin, Wei-Ning
Hsieh, Chih-Yu
Ho, Chun-Ta
Wang, Ting-Ming
Chang, Jia-Feng
author_facet Yeh, Jih-Chen
Wu, Chang-Chin
Choy, Cheuk-Sing
Chang, Shu-Wei
Liou, Jian-Chiun
Chen, Kuo-Shu
Tung, Tao-Hsin
Lin, Wei-Ning
Hsieh, Chih-Yu
Ho, Chun-Ta
Wang, Ting-Ming
Chang, Jia-Feng
author_sort Yeh, Jih-Chen
collection PubMed
description 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.
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spelling pubmed-62622792018-12-03 Non-Hepatic Alkaline Phosphatase, hs-CRP and Progression of Vertebral Fracture in Patients with Rheumatoid Arthritis: A Population-Based Longitudinal Study Yeh, Jih-Chen Wu, Chang-Chin Choy, Cheuk-Sing Chang, Shu-Wei Liou, Jian-Chiun Chen, Kuo-Shu Tung, Tao-Hsin Lin, Wei-Ning Hsieh, Chih-Yu Ho, Chun-Ta Wang, Ting-Ming Chang, Jia-Feng J Clin Med Article 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. MDPI 2018-11-13 /pmc/articles/PMC6262279/ /pubmed/30428612 http://dx.doi.org/10.3390/jcm7110439 Text en © 2018 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Yeh, Jih-Chen
Wu, Chang-Chin
Choy, Cheuk-Sing
Chang, Shu-Wei
Liou, Jian-Chiun
Chen, Kuo-Shu
Tung, Tao-Hsin
Lin, Wei-Ning
Hsieh, Chih-Yu
Ho, Chun-Ta
Wang, Ting-Ming
Chang, Jia-Feng
Non-Hepatic Alkaline Phosphatase, hs-CRP and Progression of Vertebral Fracture in Patients with Rheumatoid Arthritis: A Population-Based Longitudinal Study
title Non-Hepatic Alkaline Phosphatase, hs-CRP and Progression of Vertebral Fracture in Patients with Rheumatoid Arthritis: A Population-Based Longitudinal Study
title_full Non-Hepatic Alkaline Phosphatase, hs-CRP and Progression of Vertebral Fracture in Patients with Rheumatoid Arthritis: A Population-Based Longitudinal Study
title_fullStr Non-Hepatic Alkaline Phosphatase, hs-CRP and Progression of Vertebral Fracture in Patients with Rheumatoid Arthritis: A Population-Based Longitudinal Study
title_full_unstemmed Non-Hepatic Alkaline Phosphatase, hs-CRP and Progression of Vertebral Fracture in Patients with Rheumatoid Arthritis: A Population-Based Longitudinal Study
title_short Non-Hepatic Alkaline Phosphatase, hs-CRP and Progression of Vertebral Fracture in Patients with Rheumatoid Arthritis: A Population-Based Longitudinal Study
title_sort non-hepatic alkaline phosphatase, hs-crp and progression of vertebral fracture in patients with rheumatoid arthritis: a population-based longitudinal study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6262279/
https://www.ncbi.nlm.nih.gov/pubmed/30428612
http://dx.doi.org/10.3390/jcm7110439
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