The Correlation between Pack-Years of Smoking and Disease Activity, Quality of Life, Spinal Mobility, and Sacroiliitis Grading in Patients with Ankylosing Spondylitis

Abstract

Amaç: Bu çalışmada İranlı ankilozan spondilit (AS) hastalarında sigara paket yılı ve hastalık aktivitesi, yaşam kalitesi, spinal mobilite ve sakroileit derecelendirmesi ve AS arasındaki ilişki araştırıldı. Sonuç: Bir grup İranlı AS hastasında sigara miktarı ve hastalık aktivitesi ve yaşam kalitesi arasında bağımsız bir ilişki olduğu doğrulandı. Ayrıca içilen sigara miktarı ve spinal mobilite arasında da bir ilişki vardı; ancak bu başka ilintili faktörlere bağlıydı. Sigara içen hastalara, daha iyi sonuçlar elde etmeleri için, sigarayı bırakmaları veya daha az içmeleri telkin edilmelidir. Hastalar ve yöntemler:Anahtar sözcükler: Ankilozan spondilit; mobilite kısıtlılığı; yaşam kalitesi; sakroileit; sigara kullanımı. Objectives:This study aims to investigate the correlation between the pack-years of smoking and disease activity, quality of life, spinal mobility, and sacroiliitis grading and ankylosing spondylitis (AS) in Iranian patients with AS. Patients and methods:A total of 160 AS patients were evaluated according to their smoking status and pack-years of smoking. The outcome measures were disease activity, quality of life, spinal mobility, and sacroiliitis grading, and these were assessed by the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Ankylosing Spondylitis Quality of Life (ASQoL), Bath Ankylosing Spondylitis Metrology Index (BASMI), and radiography, respectively. Results:The smoking quantity was significantly higher in the patients with severe sacroiliitis than those with mild or moderate disease (p=0.001). A univariate analysis revealed an association between the pack-years of smoking and the BASDAI [regression coefficient (B)=0.05, standard error (SE)=0.02, 95% CI: 0.006 to 0.10; p=0.03], ASQoL (B=0.15, SE=0.06, 95% CI: 0.04 to 0.26; p=0.007), and BASMI (B=0.05, SE=0.02, 95% CI: 0.006 to 0.08; p=0.03). A multivariate analysis revealed a significant association between the packyears of smoking and the BASDAI and ASQoL. Conclusion:An independent correlation between smoking quantity with disease activity and quality of life was confirmed in a group of Iranian AS patients. There was also a relationship between smoking quantity and spinal mobility, however, it was dependent on other related factors. Patients who smoke should be encouraged to quit or smoke less to achieve a better outcome.

Increasing smoking intensity is associated with increased disease activity in axial spondyloarthritis

“…These findings are in agreement with three of the six existing studies of pack-years in AS [7, 8, 13]. Chen et al [8] reported unadjusted correlation between pack-years and BASFI, but not BASDAI, ESR or CRP.…”

“…Chen et al [8] reported unadjusted correlation between pack-years and BASFI, but not BASDAI, ESR or CRP. An Iranian study found pack-years to be associated with BASDAI and of quality of life (QoL) but not BASMI in cohort of very light current smokers (median of 0.6 pack-years) [13]. The largest and most robust study found associations between categories of pack-years and all of their markers including BASDAI, BASFI, pain numerical rating score and two measures of QoL [7].…”

“…Exploring the dose–response relationship between smoking and disease severity may provide more evidence for causal relationship. Existing studies have mostly been in small cohorts with varying results and many methodological limitations [8–13]. The aims of this study were to test the hypothesis that pack-years of cumulative exposure to cigarette smoking in ever-smokers are associated with disease activity and functional impairment in axSpA and to quantify its effect size.…”

The Quality of Life Difference between Smoker and Non Smoker Rheumatoid Arthritis and Ankylosing Spondylitis Patients

“…In the study of Hazes, the most frequent range of age at onset of complaints was 50s years [7]. Similarly, in the study of Fallahi, the most frequent range of age at onset of complaints was 30s years in patients with AS [22]. The core key result of our study was that heavily smoking was associated with early onsets of AS and RA symptoms.…”

“…When evaluated according to gender, 22.8% of women (n=18) and 69.7% of men (n=46) were smokers. Fallah et al [22] reported in their study that the smoking rate among patients with AS was 29.4%, while Hazes et al [7] reported the rate of smoking in patients with RA as 33.0%. Again, Hazes et al reported in their study that the alcohol consumption in patients with RA was 23.0%, while the rate in our study was only 7.6%.…”