Abstract
Objective To investigate the serum level of uncarboxylated matrix Gla protein (ucMGP) in ankylosing spondylitis (AS) patients,and to evaluate its diagnostic value and the relation of ucMGP to inflammation and ossification process in AS.Methods Eight-two AS patients and 76 healthy controls were enrolled in this randomized controlled study.The clinical indices (age,gender,course of disease,disease activity),changes in radiographic studies,and indices of bone metabolism or inflammation,including erythrocyte sedimentation rate (ESR),C-reactive protein (CRP),osteocalcin (OC),and bone-specific alkaline phosphatase (BALP) were evaluated or measured.The disease activity was assessed by Bath Ankylosing Spondylitis Disease Activity Index (BASDAI),and changes in radiographic pictures were evaluated according to the modified Stoke AS Spine Score (mSASSS),and serum level of ucMGP was measured by a competitive ELISA.The relationship between ucMGP and clinical indexes,radiographic scoring,indices in bone metabolism or inflammation was estimated by SPSS software,and the diagnostic value of ucMGP was analyzed by receiver operator characteristic (ROC) curve.Results The levels of ESR and CRP in AS patients were higher than those in healthy controls,but the serum ucMGP was lower (2958 ± 654nmol/L) compared with healthy controls (4551 ± 1036nmol/L,P＜0.01).RO C analysis revealed that the diagnostic specificity and sensitivity of ucMGP was 91.5％ and 69.7％ with a cut-off of 3859nmol/L (Youden index 0.612,AUC 0.825,95％ CI 0.758-0.891),and the diagnostic validity was moderate.There was no significant correlation between ucMGP and ESR,CRP,BALP,OC,BASDAI score.There was a significant negative correlation between the radiographic progression of the lesion and serum ucMGP (r=-0.715,P＜0.01).This correlation was stronger when radiographic scores rose (mSASSS＞0,r=-0.715,P＜0.01; mSASSS ＞ 1,r=-0.741,P＜0.01; mSASSS ＞10,r=-0.776,P＜0.01; mSASSS ＜10,r=-0.297,P=0.028).Conclusion Serum ucMGP may serve as a diagnostic biomarker of AS and progression index of ossification,especially in late stage of AS.关键词
Gla蛋白,基质,非羧化/脊柱炎,强直性/骨化Key words
Gla protein, matrix, uncarboxylated/spondylitis, ankylosing/ossification分类
医药卫生
