Serum BALP and CX3CL1 levels in relation to disease severity and prognosis in patients with ankylosing spondylitis
Meng Zhaozhi
Ma Yan
Gao Haicong
Zhu Wenbo
Xun Huan
Abstract：Objective To investigate the relationship between serum bone specific bone specific alkaline phospha-tase(BALP),C-X3-C motif chemokine ligand 1(CX3CL1)levels,and disease severity and prognosis in patients with ankylo-sing spondylitis(AS).Methods Retrospective collected 153 AS patients admitted to the Department of Orthopedics,Tong-chuan People's Hospital,from January 2019 to January 2024(AS group).Patients were divided into early-stage AS subgroup(41 cases),mid-stage AS subgroup(57 cases),and late-stage AS subgroup(55 cases)based on disease severity,and into unfavorable prognosis subgroup(55 cases)and favorable prognosis subgroup(98 cases)based on 6-month follow-up out-comes.Seventy healthy volunteers were included as the control group.Serum BALP and CX3CL1 levels were measured using enzyme-linked immunosorbent assay.Multivariate logistic regression was used to analyze factors influencing unfavor-able prognosis in AS patients,and receiver operating characteristic(ROC)curves were constructed to evaluate the predic-tive value of serum BALP and CX3CL1 levels for unfavorable prognosis.Results Serum BALP and CX3CL1 levels were significantly higher in the AS group compared to the control group(t/P=16.275/＜0.001,14.357/＜0.001).BALP and CX3CL1 levels increased progressively with disease severity across early-stage,mid-stage,and late-stage AS subgroups(F/P=79.259/＜0.001,84.646/＜0.001).The 6-month unfavorable prognosis rate among AS patients was 35.95％(55/153).Patients with unfavorable prognosis had higher rates of hip joint involvement,CRP,ESR,BALP,and CX3CL1 levels compared to those with favorable prognosis(t/P=27.546/＜0.001,3.943/＜0.001,4.020/＜0.001,6.245/＜0.001,7.012/＜0.001).Logistic re-gression analysis identified hip joint involvement,elevated CRP,ESR,BALP,and CX3CL1 levels as independent risk factors for unfavorable prognosis in AS[OR(95％CI)=6.641(1.993-22.131),1.092(1.009-1.182),1.203(1.089-1.329),1.039(1.020-1.059),4.644(2.145-10.056)].The AUC for predicting unfavorable prognosis using serum BALP and CX3CL1 levels and their combined assessment was 0.775,0.795,and 0.873,respectively,with the combined AUC significantly outperforming individu-al markers(Z/P=3.355/0.001,2.666/0.008).Conclusion Elevated serum BALP and CX3CL1 levels in AS patients are associ-ated with increased disease severity and poor prognosis.The combination of serum BALP and CX3CL1 levels provides high predictive efficacy for assessing prognosis in AS patients.
Keywords：Ankylosing spondylitisBone specific alkaline phosphataseC-X3-C motif chemokine ligand 1Disease severityPrognosis
Publication Date：2025-03-18
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 338-342,348 )