ORIJINAL ARAŞTIRMA
Ankilozan Spondilitli ve Non-radyografik Aksiyal Spondiloartritli Türk Hastalarda HLA-B27 Prevalansı
Prevalence of HLA-B27 in Turkish Patients with Ankylosing Spondylitis and Non-radiographic Axial Spondyloarthritis
Received Date : 16 May 2020
Accepted Date : 22 Sep 2020
Available Online : 18 Jan 2021
Ali Erhan ÖZDEMİRELa, Duygu TECERb, Şerife Şeyma TORGUTALPc, Orhan KÜÇÜKŞAHİNd
aClinic of Rheumatology, Gaziler Physical Therapy and Rehabilitation Training and Research Hospital, Ankara, TURKEY
bClinic of Rheumatology, Gülhane Training and Research Hospital, Ankara, TURKEY
cClinic of Sports Medicine, Gaziler Physical Therapy and Rehabilitation Training and Research Hospital, Ankara, TURKEY
dDepartment of Rheumatology, Ankara Yıldırım Beyazıt University Faculty of Medicine, Ankara, TURKEY
Doi: 10.31609/jpmrs.2020-76402 - Makale Dili: EN
J PMR Sci. 2021;24(1):17-22
ÖZET
Amaç: İnsan lökosit antijeni (HLA)-B27, ankilozan spondilit
(AS) ve non-radyografik aksiyal spondiloartrit (nr-axSpA) ile ilişkili
genetik bir risk faktörüdür. Türkiye’de AS’li hastalarda HLA-B27
prevalansı ile ilgili çalışmalar olmasına rağmen n-axSpA hastalarında
HLA-B27 prevalansı hakkında yeterli bilgi bulunmamaktadır. Bu
çalışmada, AS ve nr-axSpA hastalarında HLA-B27 pozitifliğinin
görülme sıklığı ve hastalık aktivitesi ile ilişkisinin değerlendirilmesi
amaçlanmıştır. Gereç ve Yöntemler: Çalışmaya, modifiye New York
ve/veya ASAS (Uluslararası Spondilo Artrit Değerlendirme Derneği)
kriterlerini karşılayan 762 AS ve 98 nr-axSpA olmak üzere toplam
860 hasta dâhil edilmiştir. Hastalık aktivitesi Bath Ankilozan
Spondilit Hastalık Aktivite İndeksi (BASDAI) ve C-reaktif protein
içeren Ankilozan Spondilit Hastalık Aktivite Skoru (ASDAS-CRP)
ile değerlendirildi. Bulgular: HLA-B27 tüm hastaların %69,3’ünde,
AS’li hastaların %70,1’inde ve nr-axSpA’lı hastaların %63,3’ünde
pozitifti. AS hastalarında daha yüksek ASDAS ve BASDAI skoru ile
HLA-B27 pozitifliği arasında anlamlı bir ilişki bulunurken, (sırasıyla;
p<0,001, p=0,002), nr-axSpA hastalarında HLA-B27 pozitifliği ile
hastalık aktivitesi arasında anlamlı bir ilişki saptanmadı (sırasıyla;
p=0,6, p=0,5). Sonuç: HLA-B27 prevalansı, Türkiye’deki AS ve nraxSpA
hastalarında nispeten düşük olup, bu durum Türkiye’nin
coğrafi konumuna ve farklı etnik yapıları içermesine atfedilebilir.
Ayrıca HLA-B27 pozitifliği AS hastalarında daha yüksek hastalık aktivitesi
ile ilişkili olup, nr-axSpA hastalarında böyle bir ilişki yoktur.
Anahtar Kelimeler: HLA-B27 antijeni; spondilit, ankilozan; prevalans
ABSTRACT
Objective: Human leukocyte antigen (HLA)-B27 is a
genetic risk factor associated with ankylosing spondylitis (AS) and nonradiographic
axial spondyloarthritis (nr-axSpA). Although there are studies
regarding the HLA-B27 prevalence in patients with AS in Turkey,
there is insufficient information on the HLA-B27 prevalence in patients
with n-axSpA. We aimed to evaluate the prevalence of HLA-B27
positivity among patients with AS and nr-axSpA, and its association
with disease activity. Material and Methods: A cross sectional study
was conducted on 860 participants (762 with AS and 98 with nraxSpA),
fulfilling the modified New York criteria and/or Assessment
of Spondyloarthritis International Society (ASAS) classification criteria.
Disease activity was assessed through the Bath Ankylosing Spondylitis
Disease Activity Index (BASDAI) and Ankylosing Spondylitis
Disease Activity Score with C-reactive protein (ASDAS-CRP). Results:
HLA-B27 was positive in 69.3% of all patients, in 70.1% of patients
with AS, and in 63.3% of patients with nr-axSpA. There was a
significant difference in HLA-B27 positivity among the AS patients
with a higher ASDAS and higher BASDAI score (respectively;
p<0.001, p=0.002), while there was no relation between the HLA-B27
positivity and disease activity in patients with nr-axSpA (p=0.6, p=0.5,
respectively). Conclusion: The prevalence of HLA-B27 is relatively
low among patients with AS and nr-axSpA in Turkey, which might be
attributed to the geographic location of Turkey leads a multi-ethnic society.
Moreover, HLA-B27 is associated with higher disease activity
in AS patients, but there is no such relationship in nr-axSpA patients.
Keywords: HLA-B27 antigen; spondylitis, ankylosing; prevalence
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