The prevalence of comorbidity and predictors in ankylosing spondylitis

Abstract

Objectives: The aim of the present study was to investigate the prevalence of comorbidities and related factors in patients with ankylosing spondylitis (AS). Patients and methods: Between June 2013 and January 2014, a total of 100 patients with AS (64 males, 36 females; mean age 43.1±10.7 years; range, 25 to 73 years) who were under routine follow-up in the outpatient clinic were included in this cross-sectional study. The demographic characteristics of the patients were recorded. The Ankylosing Spondylitis Disease Activity Scale (ASDAS), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), and Bath Ankylosing Spondylitis Metrology Index (BASMI) scores were calculated. Comorbidities were evaluated using the modified Cumulative Illness Rating Scale (CIRS). Both the number and severity of the affected systems were scored. Results: The mean amount of cigarette consumption was 17.3±13.5 pack/year. The mean disease duration was 191.3±122.4 months. The BASFI, BASDAI, BASMI, and ASDAS-C-reactive protein scores were 3.4±2.3, 3.7±2.0, 4.5±1.8, and 2.5±0.9, respectively. The mean number of system-related problems was 4.3 (range, 1 to 11). The mean CIRS scores for the severity of comorbidities were 7.36±3.48 (range, 3 to 23). The most frequent system combinations were hematopoietic, eye, ear, nose and throat, and upper gastrointestinal in 11 patients, hematopoietic, respiratory and upper gastrointestinal in 11 patients, and hematopoietic, respiratory and eye, ear, nose and throat in 10 patients. When the estimated total CIRS scores was assessed in the multivariate reduced model, age, disease duration, and BASFI values showed a significant independent effect. Conclusion: Our study results showed that the frequency of comorbidities was more than four, although the severity of system problems were mild in AS patients as measured by CIRS. The most frequently involved systems included hematopoietic, upper gastrointestinal, lower gastrointestinal, renal, and musculoskeletal-skin systems. Age, disease duration, and BASFI scores were found to be predictors of comorbidities in our patients.

Time Trend Analysis of Comorbidities in Ankylosing Spondylitis: A Population-Based Study from 53,142 Hospitalizations in Poland

“…Patients with AS are burdened with higher cardiovascular risk as compared to the general population [20,21]. Following Gökşeno glu et al [22], the population with AS is burdened with more comorbidities that also seem to affect predicted pharmacological and surgical treatment outcomes [23]. Interestingly, despite differences between the enrolled populations in terms of chronic kidney disease or diabetes [22,24], our data are consistent with other research showing that AS is not associated with an increased risk of cancer or hematological malignancies [24,25].…”

“…Following Gökşeno glu et al [22], the population with AS is burdened with more comorbidities that also seem to affect predicted pharmacological and surgical treatment outcomes [23]. Interestingly, despite differences between the enrolled populations in terms of chronic kidney disease or diabetes [22,24], our data are consistent with other research showing that AS is not associated with an increased risk of cancer or hematological malignancies [24,25]. Our first and key finding is that, despite the decline in hospitalization rates, relative mortality ratios from cardiovascular (CV) and pulmonary conditions remain higher among patients with AS compared to the observed for the general population admitted to the hospital.…”

Focal Segmental Glomerulosclerosis and Hyalinosis in a Patient with Spondyloarthritis: A Rare Renal Involvement Case Report

“… 2 , 3 Renal involvement is one of the most common extra-articular manifestations in SpA and accounts for 5–35% in SpA patients. 4 Secondary amyloidosis (AA), immunoglobulin A (IgA) nephropathy, and urolithiasis are the most common causes of SpA-associated renal involvement in the Caucasian population. 5 However, less common nephropathies such as focal segmental glomerulosclerosis and hyalinosis (FSGS) can be seen in SpA and are limited to rare case reports.…”

Anemia in Patients With Ankylosing Spondylitis, Association With the Activity of the Inflammatory Process and the Severity of the Disease

“…Anemia of varying degrees of severity often occurs in patients with ankylosing spondylitis. According to epidemiological studies, anemic syndrome with AS occurs in 18,5-45,8% of cases [1,2,3,4,5,6]. The main types of anemia in patients with AS are anemia of chronic disease (ACD) (33,3% -78,7%) and iron deficiency anemia (IDA) (21,28% -66,7%) cases [1,3].…”

“…The main causes of IDA are bleeding due to ulceration of the intestinal mucosa (especially in patients taking large doses of nonsteroidal anti-inflammatory drugs (NSAIDs) ) [6], restriction of iron-containing products in food and reduced intestinal absorption of iron [4]. Inflammatory cytokines (IL-1, IL-6) may also aggravate the absorption of iron in the intestine due to hepcidin induced disintegration of ferroportin.…”