title: [Effects of comprehensive therapy on serum SPARC levels in ankylosing spondylitis patients accompanied with osteoporosis].
abstract: OBJECTIVE
  To observe the effects of comprehensive therapy on serum secreted protein acidic and rich in cysteine (SPARC) levels in ankylosing spondylitis (AS) patients accompanied with osteoporosis (OP), and to explore the possible mechanisms for SPARC in AS patients accompanied with osteoporosis.
  
  
  METHODS
  Totally 48 AS patients accompanied with OP (Group A) were treated with massage, intravenous infusion of Cervus and Cucumis Polypeptide Injection, and Bushen Quhan Zhiwang Decoction (BQZD) for 3 months. At the same time, 45 normal healthy subjects were recruited as the normal control group (Group B). Serum SPARC levels were measured by ELISA in Group A before and after comprehensive therapy and in those of Group B. The levels of bone mineral density of femoral neck (FN BMD), bone mineral density of 2 -4 lumbar spine (L2-4 BMD), bone specific alkaline phosphatase (BSAP), tumor necrosis factor alpha (TNF-alpha), and transforming growth factor beta-1 (TGF-beta1) were detected. Meanwhile, Bath AS disease activity index (BASDAI) and Bath AS functional index (BASFI) were detected in Group A before and after treatment. The correlations between the aforesaid indices and serum SPARC levels were analyzed.
  
  
  RESULTS
  Serum SPARC levels were significantly lower in those of Group A than in those of Group B (175. 30 +/- 72.04 micro/L vs 190. 52 +/- 86. 13 microg/ L, P <0. 01). Serum SPARC levels in those of Group A were negatively correlated with TNF-alpha (r = -0.261, P <0.01), positively with L2-4 BMD, TGF-beta1, and BSAP (r =0.437,0.256, 0.385, P <0.05, P <0.01). L2-4BMD and BSAP were independently predictors of serum SPARC in patients of Group A. After comprehensive therapy, the levels of TNF-alpha, BASDAI, and BASFI obviously decreased, TGF-beta1, BSAP, L2-4 BMD, and FN BMD obviously increased (P <0. 05, P <0. 01). The serum SPARC levels also significantly increased (188.32 +/- 87.50 microg/L, P <0. 05).
  
  
  CONCLUSIONS
  Comprehensive therapy could effectively improve the bone metabolism, clinical symptoms and the activity function of joints, and elevate serum SPARC levels.
authors.affiliation: Department of Traumatology, Shanghai East Hospital Affiliated to Tongji University, Shanghai 200120, China. xujingren2@126.com
authors.forename: Jing-ren
authors.initials: JR
authors.lastname: Xu
authors.forename: Yan
authors.initials: Y
authors.lastname: Lin
authors.forename: Chun-Yan
authors.initials: CY
authors.lastname: Zhang
authors.forename: Wei-Min
authors.initials: WM
authors.lastname: Li
authors.forename: Chen-Jun
authors.initials: CJ
authors.lastname: Guo
authors.forename: Lei
authors.initials: L
authors.lastname: Ye
mesh_terms: D000293:Adolescent; D000328:Adult; D015519:Bone Density; D016022:Case-Control Studies; D003131:Combined Modality Therapy; D003545:Cysteine / Q000097:blood; D004365:Drugs, Chinese Herbal / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015676:Osteonectin / Q000097:blood*; D010024:Osteoporosis / Q000097:blood* / Q000150:complications / Q000628:therapy; D013167:Spondylitis, Ankylosing / Q000097:blood* / Q000150:complications / Q000628:therapy; D055815:Young Adult
chemical_list: D004365:Drugs, Chinese Herbal; D015676:Osteonectin; C577241:SPARC protein, human; D003545:Cysteine