scholarly journals Polygenic Risk Scores have high diagnostic capacity in ankylosing spondylitis

2021 ◽  
pp. annrheumdis-2020-219446
Author(s):  
Zhixiu Li ◽  
Xin Wu ◽  
Paul J Leo ◽  
Erika De Guzman ◽  
Nurullah Akkoc ◽  
...  
Keyword(s):  
Back Pain ◽  
Chronic Back Pain ◽  
East Asian ◽  
Risk Scores ◽  
Hla B27 ◽  
C Reactive Protein ◽  
European Descent ◽  
Polygenic Risk ◽  
Reactive Protein ◽  
Discriminatory Capacity

ObjectiveWe sought to test the hypothesis that Polygenic Risk Scores (PRSs) have strong capacity to discriminate cases of ankylosing spondylitis (AS) from healthy controls and individuals in the community with chronic back pain.MethodsPRSs were developed and validated in individuals of European and East Asian ethnicity, using data from genome-wide association studies in 15 585 AS cases and 20 452 controls. The discriminatory values of PRSs in these populations were compared with other widely used diagnostic tests, including C-reactive protein (CRP), HLA-B27 and sacroiliac MRI.ResultsIn people of European descent, PRS had high discriminatory capacity with area under the curve (AUC) in receiver operator characteristic analysis of 0.924. This was significantly better than for HLA-B27 testing alone (AUC=0.869), MRI (AUC=0.885) or C-reactive protein (AUC=0.700). PRS developed and validated in individuals of East Asian descent performed similarly (AUC=0.948). Assuming a prior probability of AS of 10% such as in patients with chronic back pain under 45 years of age, compared with HLA-B27 testing alone, PRS provides higher positive values for 35% of patients and negative predictive values for 67.5% of patients. For PRS, in people of European descent, the maximum positive predictive value was 78.2% and negative predictive value was 100%, whereas for HLA-B27, these values were 51.9% and 97.9%, respectively.ConclusionsPRS have higher discriminatory capacity for AS than CRP, sacroiliac MRI or HLA-B27 status alone. For optimal performance, PRS should be developed for use in the specific ethnic groups to which they are to be applied.

scholarly journals Polygener Risikoscore hilft bei der Diagnose der Spondylitis akylosans

2021 ◽  
pp. 1-3
Author(s):  
Carmen-Marina Mihai
Keyword(s):  
Back Pain ◽  
Predictive Value ◽  
Chronic Back Pain ◽  
East Asian ◽  
Genome Wide Association Studies ◽  
Hla B27 ◽  
C Reactive Protein ◽  
European Descent ◽  
Reactive Protein ◽  
Discriminatory Capacity

<b>Objective:</b> We sought to test the hypothesis that Polygenic Risk Scores (PRSs) have strong capacity to discriminate cases of ankylosing spondylitis (AS) from healthy controls and individuals in the community with chronic back pain. <b>Methods:</b> PRSs were developed and validated in individuals of European and East Asian ethnicity, using data from genome-wide association studies in 15 585 AS cases and 20 452 controls. The discriminatory values of PRSs in these populations were compared with other widely used diagnostic tests, including C-reactive protein (CRP), HLA-B27 and sacroiliac MRI. <b>Results:</b> In people of European descent, PRS had high discriminatory capacity with area under the curve (AUC) in receiver operator characteristic analysis of 0.924. This was significantly better than for HLA-B27 testing alone (AUC = 0.869), MRI (AUC = 0.885) or C-reactive protein (AUC = 0.700). PRS developed and validated in individuals of East Asian descent performed similarly (AUC = 0.948). Assuming a prior probability of AS of 10% such as in patients with chronic back pain under 45 years of age, compared with HLA-B27 testing alone, PRS provides higher positive values for 35% of patients and negative predictive values for 67.5% of patients. For PRS, in people of European descent, the maximum positive predictive value was 78.2% and negative predictive value was 100%, whereas for HLA-B27, these values were 51.9% and 97.9%, respectively. <b>Conclusions:</b> PRS have higher discriminatory capacity for AS than CRP, sacroiliac MRI or HLA-B27 status alone. For optimal performance, PRS should be developed for use in the specific ethnic groups to which they are to be applied.

scholarly journals Joint evaluation of serum C-Reactive Protein levels and polygenic risk scores as risk factors for schizophrenia

2018 ◽  
Vol 261 ◽  
pp. 148-153 ◽  
Author(s):  
Vishwajit L. Nimgaonkar ◽  
Faith Dickerson ◽  
Jennie G. Pouget ◽  
Kodavali Chowdari ◽  
Colm O’Dushlaine ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Scores ◽  
C Reactive Protein ◽  
Polygenic Risk ◽  
Protein Levels ◽  
Reactive Protein ◽  
Joint Evaluation

scholarly journals Predictive values of inflammatory back pain, positive HLA B27 antigen and acute and chronic magnetic resonance changes in early diagnosis of Spondyloarthritis. A study of 133 patients

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0244184
Author(s):  
Liliya Yankova Komsalova ◽  
Mª Pilar Martínez Salinas ◽  
José Fermín Gómez Jiménez
Keyword(s):  
Back Pain ◽  
Magnetic Resonance ◽  
Early Diagnosis ◽  
Inflammatory Back Pain ◽  
Hla B27 ◽  
C Reactive Protein ◽  
Predictive Values ◽  
Reactive Protein ◽  
Great Specificity ◽  
Weighted Sequences

Objectives To analyse the predictive values of inflammatory back pain (IBP), positive HLA B27 antigen, increased C-reactive protein (CRP), Spondyloarthritis (SpA) features, familial history (FH), magnetic resonance sacroiliac joints (MRI-SIJ) imaging and its weight in early SpA diagnosis. Methods 133 patients with back pain, aged <50, duration of the pain <2 years were included. Data such as IBP, HLA B27, increased CRP, SpA features, FH, SIJ´s radiography and MRI were collected for each patient. STIR sequences were classified as strongly positive bone morrow oedema (SPBME ≥2), clearly present and easily recognisable as positive according to the ASAS criterion, weakly positive (WPBME ≥2), suggestive, but not easily recognisable and, clearly negative none of those features. T1-weighted sequences were assessed as positive/negative for erosion, fat metaplasia, backfill and sclerosis, if ≥1, for each lesion was present. MRI images were read by three blinded readers. Results The average age was 38.9 years. 47 (35.3%) patients received SpA diagnosis according to the clinical opinion. IBP was highly specific, 0.81 and sensitive, 0.83. HLA B27 was positive in a half of the SpA patients. SPBME ≥2 provided a great specificity, 0.94 and an acceptable sensitivity, 0.79. Erosion was significantly more frequent in SpA patients (72% vs 7%), specificity 0.93. The addition of erosion ≥1 to the WPBME ≥2 noticeably improved specificity, 0.98, although slightly decreased sensitivity, 0.64. Fat metaplasia and backfill were highly specific, but poorly sensitive. Factors forecasting positive diagnosis were IBP, followed by SpA features and increased CRP. Conclusions At the onset, IBP might be a good marker for selecting patients with suspicion of SpA. The addition of erosion to the ASAS criterion might be helpful for early diagnosis, especially in patients with doubtful STIR imaging where BME is present but it is hard to determinate whether the ASAS “highly suggestive” criterion is met.

Multi-trajectory analysis of C-reactive protein and low back pain from adolescence to early adulthood

2021 ◽  
Author(s):  
Amber M Beynon ◽  
Jeffrey J Hebert ◽  
Darren J Beales ◽  
Angela Jacques ◽  
Bruce F Walker
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Trajectory Analysis ◽  
Early Adulthood ◽  
Low Back ◽  
C Reactive Protein ◽  
Reactive Protein

General v. specific vulnerabilities: polygenic risk scores and higher-order psychopathology dimensions in the Adolescent Brain Cognitive Development (ABCD) Study

2021 ◽  
pp. 1-10
Author(s):  
Monika A. Waszczuk ◽  
Jiaju Miao ◽  
Anna R. Docherty ◽  
Andrey A. Shabalin ◽  
Katherine G. Jonas ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Behavioral Problems ◽  
Mental Health Problems ◽  
Chronic Back Pain ◽  
European Ancestry ◽  
Risk Scores ◽  
General Factor ◽  
Childhood Psychopathology ◽  
Polygenic Risk ◽  
Partial Correlations

Abstract Background Polygenic risk scores (PRSs) capture genetic vulnerability to psychiatric conditions. However, PRSs are often associated with multiple mental health problems in children, complicating their use in research and clinical practice. The current study is the first to systematically test which PRSs associate broadly with all forms of childhood psychopathology, and which PRSs are more specific to one or a handful of forms of psychopathology. Methods The sample consisted of 4717 unrelated children (mean age = 9.92, s.d. = 0.62; 47.1% female; all European ancestry). Psychopathology was conceptualized hierarchically as empirically derived general factor (p-factor) and five specific factors: externalizing, internalizing, neurodevelopmental, somatoform, and detachment. Partial correlations explored associations between psychopathology factors and 22 psychopathology-related PRSs. Regressions tested which level of the psychopathology hierarchy was most strongly associated with each PRS. Results Thirteen PRSs were significantly associated with the general factor, most prominently Chronic Multisite Pain-PRS (r = 0.098), ADHD-PRS (r = 0.079), and Depression-PRS (r = 0.078). After adjusting for the general factor, Depression-PRS, Neuroticism-PRS, PTSD-PRS, Insomnia-PRS, Chronic Back Pain-PRS, and Autism-PRS were not associated with lower order factors. Conversely, several externalizing PRSs, including Adventurousness-PRS and Disinhibition-PRS, remained associated with the externalizing factor (|r| = 0.040–0.058). The ADHD-PRS remained uniquely associated with the neurodevelopmental factor (r = 062). Conclusions PRSs developed to predict vulnerability to emotional difficulties and chronic pain generally captured genetic risk for all forms of childhood psychopathology. PRSs developed to predict vulnerability to externalizing difficulties, e.g. disinhibition, tended to be more specific in predicting behavioral problems. The results may inform translation of existing PRSs to pediatric research and future clinical practice.

scholarly journals Is a positive family history of spondyloarthritis relevant for diagnosing axial spondyloarthritis once HLA-B27 status is known?

Rheumatology ◽  
2019 ◽  
Vol 58 (9) ◽  
pp. 1649-1654 ◽  
Author(s):  
Miranda van Lunteren ◽  
Désirée van der Heijde ◽  
Alexandre Sepriano ◽  
Inger J Berg ◽  
Maxime Dougados ◽  
...  
Keyword(s):  
Back Pain ◽  
Family History ◽  
Anterior Uveitis ◽  
Chronic Back Pain ◽  
Axial Spondyloarthritis ◽  
Positive Family History ◽  
Hla B27 ◽  
Acute Anterior Uveitis ◽  
Negative Results ◽  
History Of

Abstract Objectives A positive family history (PFH) of spondyloarthritis, in particular a PFH of AS or acute anterior uveitis, is associated with HLA-B27 carriership in chronic back pain patients. As it is unknown, the study aimed to investigate if a PFH contributes to diagnosing axial spondyloarthritis (axSpA) once HLA-B27 status is known. Methods In axSpA-suspected patients from the Assessment of SpondyloArthritis international Society (ASAS), DEvenir des Spondyloarthropathies Indifférenciéés Récentes (DESIR) and SPondyloArthritis Caught Early (SPACE) cohorts, logistic regression analyses were performed with HLA-B27 status and PFH according to the ASAS definition (ASAS-PFH) as determinants and clinical axSpA diagnosis as outcome at baseline. Analyses were repeated with a PFH of AS or acute anterior uveitis. Results In total, 1818 patients suspected of axSpA were analysed (ASAS n = 594, DESIR n = 647, and SPACE n = 577). In patients from the ASAS, DESIR and SPACE cohorts, respectively 23%, 39% and 38% had an ASAS-PFH, 52%, 58% and 43% were HLA-B27 positive, and 62%, 47% and 54% were diagnosed with axSpA. HLA-B27 was independently associated with an axSpA diagnosis in each cohort but an ASAS-PFH was not [ASAS cohort: HLA-B27 odds ratio (OR): 6.9 (95% CI: 4.7, 10.2), ASAS-PFH OR: 0.9 (95% CI: 0.6, 1.4); DESIR: HLA-B27 OR: 2.1 (95% CI: 1.5, 2.9), ASAS-PFH OR: 1.0 (95% CI 0.7, 1.3); SPACE: HLA-B27 OR: 10.4 (95% CI: 6.9, 15.7), ASAS-PFH OR: 1.0 (95% CI: 0.7, 1.5)]. Similar negative results were found for PFH of AS and acute anterior uveitis. Conclusion In three independent cohorts with different ethnical backgrounds, ASAS, DESIR and SPACE, a PFH was not associated independently of HLA-B27 with a diagnosis of axSpA. This indicates that in the vast majority of patients presenting with back pain, a PFH does not contribute to the likelihood of an axSpA diagnosis if HLA-B27 status is known.

Relations of C-Reactive Protein and Obesity to the Prevalence and the Odds of Reporting Low Back Pain

2013 ◽  
Vol 94 (4) ◽  
pp. 745-752 ◽  
Author(s):  
Matthew S. Briggs ◽  
Deborah L. Givens ◽  
Laura C. Schmitt ◽  
Christopher A. Taylor
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Low Back ◽  
C Reactive Protein ◽  
Reactive Protein

scholarly journals The association between insomnia, c-reactive protein, and chronic low back pain: cross-sectional analysis of the HUNT study, Norway

2019 ◽  
Vol 19 (4) ◽  
pp. 765-777 ◽  
Author(s):  
Kevin Kwan Ngai Ho ◽  
Milena Simic ◽  
Milada Cvancarova Småstuen ◽  
Marina de Barros Pinheiro ◽  
Paulo Herrique Ferreira ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Total Sample ◽  
Low Back ◽  
C Reactive Protein ◽  
Cross Sectional ◽  
Reactive Protein ◽  
Sectional Analysis ◽  
Very High

Abstract Background and aims Chronic low back pain (chronic LBP) is the number one cause for years lived with disability among 301 diseases and injuries analyzed by The Global Burden of Disease study 2013. Insomnia is highly prevalent among people with chronic LBP. To explain the sleep-pain relationship, theoretical models propose that insomnia symptoms may be associated with increased basal inflammation, operationalized as c-reactive protein (CRP) and lead to further pain and disrupted sleep. We aimed to determine the associations between insomnia, chronic LBP, and inflammation (operationalized as CRP), whilst controlling for age, body mass index, smoking, physical activity, depression, anxiety and osteoarthritis. Methods A cross-sectional analysis of the third Nord-Trøndelag Health Study (2006–2008), a rural population survey of 50,666 participants in Norway aged 20–96 years. Insomnia (dichotomous) was defined according to the Diagnostic and Statistical Manual of Mental Disorders 5th Edition, and chronic LBP (dichotomous) as low back pain or stiffness lasting at least 3 months. Data for CRP were obtained from non-fasting serum samples and assessed via latex immunoassay methodology. We excluded participants with the following self-reported chronic somatic diseases: chronic heart failure, chronic obstructive pulmonary disease, rheumatoid arthritis, fibromyalgia or ankylosing spondylosis. Possible associations between presence of insomnia and presence of chronic LBP (dependent), and the level of CRP and presence of chronic LBP (dependent), were assessed using logistic regression models. The possible association between insomnia and CRP (dependent) was assessed using linear regression. Multivariable analyses were conducted adjusting for confounders stated in our aim that achieved p ≤ 0.2 in univariate regressions. We performed stratified analyses for participants with “Normal” (<3 mg/L) “Elevated” (3–10 mg/L) and “Very High” (>10 mg/L) levels of CRP. Results In our total included sample (n = 30,669, median age 52.6, 54% female), 6.1% had insomnia (n = 1,871), 21.4% had chronic LBP (n = 6,559), and 2.4% had both (n = 719). Twenty four thousand two hundred eighty-eight (79%) participants had “Normal” CRP, 5,275 (17%) had “Elevated” CRP, and 1,136 (4%) had “Very High” CRP. For participants with “Normal” levels of CRP, insomnia was associated with higher levels of CRP (adjusted B = 0.04, 95%CI [0.00–0.08], p = 0.046), but not for people with “Elevated” or “Very High” levels of CRP. There was an association between CRP and presence of chronic LBP in the total sample (adjusted OR = 1.01, [1.00–1.01], p = 0.013) and for people with “Normal” CRP (1.05, [1.00–1.10, p = 0.034]. Insomnia was associated with the presence of chronic LBP in the total sample (adjusted OR = 1.99, 95%CI [1.79–2.21], <0.001) and for people with “Normal”, “Elevated” and “Very High”. Conclusions Individuals with insomnia have twice the odds of reporting chronic LBP. Insomnia, CRP and chronic LBP appear to be linked but the role of CRP appears to be limited. Longitudinal studies may help further explore the causal inference between insomnia chronic LBP, and inflammation. Implications Given the strong relationship between insomnia and chronic LBP, screening and management of comorbid insomnia and chronic LBP should be considered in clinical practice. Further longitudinal studies are required to explore whether the presence of insomnia and increased inflammation affects the development of chronic LBP.

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