Interaction effects of significant risk factors on low bone mineral density in ankylosing spondylitis
Background To analyze individually and interactively critical risk factors, which are closely related to low bone mineral density (BMD) in patient with ankylosing spondylitis (AS). Methods A total of 249 AS patients who visited China-Japan Friendship Hospital were included in this training set. Pati...
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PeerJ Inc.
2023-11-01
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| Online Access: | https://peerj.com/articles/16448.pdf |
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| author | Wenting Sun Wenjun Mu Caroline Jefferies Thomas Learch Mariko Ishimori Juan Wu Zeran Yan Nan Zhang Qingwen Tao Weiping Kong Xiaoping Yan Michael H. Weisman |
| author_facet | Wenting Sun Wenjun Mu Caroline Jefferies Thomas Learch Mariko Ishimori Juan Wu Zeran Yan Nan Zhang Qingwen Tao Weiping Kong Xiaoping Yan Michael H. Weisman |
| author_sort | Wenting Sun |
| collection | DOAJ |
| description | Background To analyze individually and interactively critical risk factors, which are closely related to low bone mineral density (BMD) in patient with ankylosing spondylitis (AS). Methods A total of 249 AS patients who visited China-Japan Friendship Hospital were included in this training set. Patients with questionnaire data, blood samples, X-rays, and BMD were collected. Logistic regression analysis was employed to identify key risk factors for low BMD in different sites, and predictive accuracy was improved by incorporating the selected significant risk factors into the baseline model, which was then validated using a validation set. The interaction between risk factors was analyzed, and predictive nomograms for low BMD in different sites were established. Results There were 113 patients with normal BMD, and 136 patients with low BMD. AS patients with hip involvement are more likely to have low BMD in the total hip, whereas those without hip involvement are more prone to low BMD in the lumbar spine. Chest expansion, mSASSS, radiographic average grade of the sacroiliac joint, and hip involvement were significantly associated with low BMD of the femoral neck and total hip. Syndesmophytes, hip involvement and higher radiographic average grade of the sacroiliac joint increases the risk of low BMD of the femoral neck and total hip in an additive manner. Finally, a prediction model was constructed to predict the risk of low BMD in total hip and femoral neck. Conclusions This study identified hip involvement was strongly associated with low BMD of the total hip in AS patients. Furthermore, the risk of low BMD of the femoral neck and total hip was found to increase in an additive manner with the presence of syndesmophytes, hip involvement, and severe sacroiliitis. This finding may help rheumatologists to identify AS patients who are at a high risk of developing low BMD and prompt early intervention to prevent fractures. |
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| language | English |
| last_indexed | 2024-03-09T16:28:42Z |
| publishDate | 2023-11-01 |
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| spelling | doaj.art-b14fbdc2cec34b3dabdb1d8933c45c482023-11-24T15:05:17ZengPeerJ Inc.PeerJ2167-83592023-11-0111e1644810.7717/peerj.16448Interaction effects of significant risk factors on low bone mineral density in ankylosing spondylitisWenting Sun0Wenjun Mu1Caroline Jefferies2Thomas Learch3Mariko Ishimori4Juan Wu5Zeran Yan6Nan Zhang7Qingwen Tao8Weiping Kong9Xiaoping Yan10Michael H. Weisman11China Academy of Chinese Medical Sciences, Beijing, ChinaBeijing University of Chinese Medicine, Beijing, ChinaDivision of Rheumatology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, United States of AmericaDepartment of Radiology, Cedars-Sinai Medical Center, Los Angeles, United States of AmericaDivision of Rheumatology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, United States of AmericaBeijing University of Chinese Medicine, Beijing, ChinaBeijing Key Lab for Immune-Mediated Inflammatory Diseases, China-Japan Friendship Hospital, Beijing, ChinaBeijing Key Lab for Immune-Mediated Inflammatory Diseases, China-Japan Friendship Hospital, Beijing, ChinaBeijing Key Lab for Immune-Mediated Inflammatory Diseases, China-Japan Friendship Hospital, Beijing, ChinaBeijing Key Lab for Immune-Mediated Inflammatory Diseases, China-Japan Friendship Hospital, Beijing, ChinaBeijing Key Lab for Immune-Mediated Inflammatory Diseases, China-Japan Friendship Hospital, Beijing, ChinaStanford University, Stanford, California, United States of AmericaBackground To analyze individually and interactively critical risk factors, which are closely related to low bone mineral density (BMD) in patient with ankylosing spondylitis (AS). Methods A total of 249 AS patients who visited China-Japan Friendship Hospital were included in this training set. Patients with questionnaire data, blood samples, X-rays, and BMD were collected. Logistic regression analysis was employed to identify key risk factors for low BMD in different sites, and predictive accuracy was improved by incorporating the selected significant risk factors into the baseline model, which was then validated using a validation set. The interaction between risk factors was analyzed, and predictive nomograms for low BMD in different sites were established. Results There were 113 patients with normal BMD, and 136 patients with low BMD. AS patients with hip involvement are more likely to have low BMD in the total hip, whereas those without hip involvement are more prone to low BMD in the lumbar spine. Chest expansion, mSASSS, radiographic average grade of the sacroiliac joint, and hip involvement were significantly associated with low BMD of the femoral neck and total hip. Syndesmophytes, hip involvement and higher radiographic average grade of the sacroiliac joint increases the risk of low BMD of the femoral neck and total hip in an additive manner. Finally, a prediction model was constructed to predict the risk of low BMD in total hip and femoral neck. Conclusions This study identified hip involvement was strongly associated with low BMD of the total hip in AS patients. Furthermore, the risk of low BMD of the femoral neck and total hip was found to increase in an additive manner with the presence of syndesmophytes, hip involvement, and severe sacroiliitis. This finding may help rheumatologists to identify AS patients who are at a high risk of developing low BMD and prompt early intervention to prevent fractures.https://peerj.com/articles/16448.pdfRisk factorLow bone mineral densityAnkylosing spondylitisInteraction effectHip involvementFemoral neck |
| spellingShingle | Wenting Sun Wenjun Mu Caroline Jefferies Thomas Learch Mariko Ishimori Juan Wu Zeran Yan Nan Zhang Qingwen Tao Weiping Kong Xiaoping Yan Michael H. Weisman Interaction effects of significant risk factors on low bone mineral density in ankylosing spondylitis PeerJ Risk factor Low bone mineral density Ankylosing spondylitis Interaction effect Hip involvement Femoral neck |
| title | Interaction effects of significant risk factors on low bone mineral density in ankylosing spondylitis |
| title_full | Interaction effects of significant risk factors on low bone mineral density in ankylosing spondylitis |
| title_fullStr | Interaction effects of significant risk factors on low bone mineral density in ankylosing spondylitis |
| title_full_unstemmed | Interaction effects of significant risk factors on low bone mineral density in ankylosing spondylitis |
| title_short | Interaction effects of significant risk factors on low bone mineral density in ankylosing spondylitis |
| title_sort | interaction effects of significant risk factors on low bone mineral density in ankylosing spondylitis |
| topic | Risk factor Low bone mineral density Ankylosing spondylitis Interaction effect Hip involvement Femoral neck |
| url | https://peerj.com/articles/16448.pdf |
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