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Clinical and laboratory factors associated with bamboo spine in patients with axial spondyloarthritis: are there clues for bamboo spine?

1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23

 

  1. Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Marmara University, Hatay, Turkey. pamir.atagunduz@gmail.com
  2. Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
  3. Division of Rheumatology, Department of Internal Medicine, Izmir Katip Celebi University School of Medicine, Izmir, Turkey.
  4. Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Yıldırım Beyazıt University, Ankara, Turkey.
  5. Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Yıldırım Beyazıt University, Ankara, Turkey.
  6. Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Marmara University, Hatay, Turkey.
  7. Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Uludag University, Bursa, Turkey.
  8. Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Uludag University, Bursa, Turkey.
  9. Division of Rheumatology, Department of Internal Medicine, University of Health Sciences, Cam and Sakura City Hospital, Istanbul, Turkey.
  10. Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Koc University, İstanbul, Turkey.
  11. Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
  12. Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
  13. Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey.
  14. Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Trakya University, Edirne, Turkey.
  15. University of Health Sciences, Gulhane Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Ankara, Turkey.
  16. Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Hatay Mustafa Kemal University, Hatay, Turkey.
  17. Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Akdeniz University, Antalya, Turkey.
  18. Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Ankara University, Ankara, Turkey.
  19. Department of Internal Medicine, Division of Rheumatology, Ministry of Health Adana City Training and Research Hospital, Adana, Turkey.
  20. Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Sakarya University, Sakarya, Turkey.
  21. Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Tekirdag Namik Kemal University, Tekirdag, Turkey.
  22. Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
  23. Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey.

CER15388
2023 Vol.41, N°3
PI 0620, PF 0627
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PMID: 35766019 [PubMed]

Received: 04/12/2021
Accepted : 12/05/2022
In Press: 28/06/2022
Published: 23/03/2023

Abstract

OBJECTIVES:
To analyse the clinical and laboratory factors associated with bamboo spine.
METHODS:
Data of patients fulfilling the 2009 ASAS classification criteria for axial spondyloarthritis, registered in the national, multicentre, longitudinal, and observational database of TReasure was analysed. Radiographs were assessed using the Bath Ankylosing Spondylitis Radiologic Index (BASRI). Data of patients with a bamboo spine (Group 1) was compared to data derived from patients with a longstanding disease of at least 15 years but no syndesmophytes (Group 2).
RESULTS:
Out of the 5060 patients, 1246 had eligible radiographs. There were 111 patients (8.9%) with a bamboo spine. Male sex was more common among patients with bamboo spine. The median BMI of 27.7 (25.8-31.1) in Group1 was higher than the BMI of 25.9 (22.9-29.2) in Group 2 (p<0.001). Hip arthritis, present or documented by a physician, was more common in Group 1 [(58/108 (53.7%) vs. 35/103 (34%), p=0.004]. There was a tendency towards a more prevalent enthesitis in these patients [29.1% (25/86) vs. 15.9%(11/69), p=0.054]. HLA-B27 status did not differ between groups. Smoking was more prevalent in Group 1. Multivariate logistic regression analysis revealed that male sex, body mass index, hip arthritis, and enthesitis are associated with bamboo spine in axSpA.
CONCLUSIONS:
Bamboo spine was more common in the male sex and associated with a delay in diagnosis, high BMI, hip involvement, and enthesitis. The constellation of increased body weight, hip arthritis, and enthesitis may imply that mechanical stress contributes to radiographic damage in the presence of chronic inflammation.

DOI: https://doi.org/10.55563/clinexprheumatol/eb1zpo

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