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

Jih-Chen Yeh, Chang-Chin Wu, Cheuk-Sing Choy, Shu-Wei Chang, Jian-Chiun Liou, Kuo-Shu Chen, Tao-Hsin Tung, Wei-Ning Lin, Chih-Yu Hsieh, Chun-Ta Ho, Ting-Ming Wang, Jia-Feng Chang

研究成果: 雜誌貢獻文章

摘要

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
原文英語
期刊Journal of Clinical Medicine
7
發行號11
DOIs
出版狀態已發佈 - 十一月 13 2018

指紋

C-Reactive Protein
Alkaline Phosphatase
Longitudinal Studies
Rheumatoid Arthritis
Population
Confidence Intervals
Biomarkers
Serum
Proportional Hazards Models

Keywords

  • alkaline phosphatase
  • C-reactive protein
  • rheumatoid arthritis
  • vertebral fractures

引用此文

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.

於: Journal of Clinical Medicine, 卷 7, 編號 11, 13.11.2018.

研究成果: 雜誌貢獻文章

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. 於: Journal of Clinical Medicine. 2018 ; 卷 7, 編號 11.
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title = "Non-Hepatic Alkaline Phosphatase, hs-CRP and Progression of Vertebral Fracture in Patients with Rheumatoid Arthritis: A Population-Based Longitudinal Study",
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.",
keywords = "alkaline phosphatase, C-reactive protein, rheumatoid arthritis, vertebral fractures",
author = "Jih-Chen Yeh and Chang-Chin Wu and Cheuk-Sing Choy and Shu-Wei Chang and Jian-Chiun Liou and Kuo-Shu Chen and Tao-Hsin Tung and Wei-Ning Lin and Chih-Yu Hsieh and Chun-Ta Ho and Ting-Ming Wang and Jia-Feng Chang",
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doi = "10.3390/jcm7110439",
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volume = "7",
journal = "Journal of Clinical Medicine",
issn = "2077-0383",
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TY - JOUR

T1 - Non-Hepatic Alkaline Phosphatase, hs-CRP and Progression of Vertebral Fracture in Patients with Rheumatoid Arthritis

T2 - A Population-Based Longitudinal Study

AU - Yeh, Jih-Chen

AU - Wu, Chang-Chin

AU - Choy, Cheuk-Sing

AU - Chang, Shu-Wei

AU - Liou, Jian-Chiun

AU - Chen, Kuo-Shu

AU - Tung, Tao-Hsin

AU - Lin, Wei-Ning

AU - Hsieh, Chih-Yu

AU - Ho, Chun-Ta

AU - Wang, Ting-Ming

AU - Chang, Jia-Feng

PY - 2018/11/13

Y1 - 2018/11/13

N2 - 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.

AB - 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.

KW - alkaline phosphatase

KW - C-reactive protein

KW - rheumatoid arthritis

KW - vertebral fractures

U2 - 10.3390/jcm7110439

DO - 10.3390/jcm7110439

M3 - Article

C2 - 30428612

VL - 7

JO - Journal of Clinical Medicine

JF - Journal of Clinical Medicine

SN - 2077-0383

IS - 11

ER -