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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...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2018
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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. |
format | Online Article Text |
id | pubmed-6262279 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
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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