title: The effect of smoking on clinical and radiographic variables, and acute phase reactants in patients with ankylosing spondylitis.
abstract: To investigate the association between smoking and clinical, inflammatory and radiographic parameters in patients with ankylosing spondylitis (AS). One hundred and six tumour necrosis factor inhibitor naïve patients with AS were included in the study. The erythrocyte sedimentation rate, C-reactive protein, Bath AS Disease Activity Index (BASDAI), Bath AS Functional Index (BASFI) and modified Stroke AS Spine Score (mSASSS) were assessed cross-sectionally for each patient. Smoking history was obtained, and smoking pack years were calculated. Current smokers had significantly higher BASDAI (p < 0.001) and a trend for higher BASFI (p = 0.059). Ever smokers had significantly higher BASFI (p = 0.035) and a trend for higher mSASSS (p = 0.063) compared to never smokers. Pack years (smoking intensity) were positively correlated with duration of inflammatory back pain (r = 0.628, p < 0.001), BASFI (r = 0.443, p < 0.001) and mSASSS (r = 0.683, p < 0.001). Multivariate regression analyses showed that current smoking was independently associated with a higher BASDAI score [regression coefficient (B) = 14.75, p < 0.001] and increasing pack years were independently associated with higher mSASSS (B = 0.26, p = 0.005). In patients with AS, current smoking was strongly and independently associated with higher disease activity, and cumulative smoking exposure with more radiographic spinal damage. In AS smokers, smoking cessation should be strongly recommended.
authors.affiliation: Department of Rheumatology, 424 General Military Hospital, Ring Road, N.Efkarpia, 564 03, Thessaloníki, Greece. sakelgr@gmail.com.
authors.forename: Grigorios T
authors.initials: GT
authors.lastname: Sakellariou
authors.affiliation: Department of Endocrinology, 424 General Military Hospital, Thessaloníki, Greece.
authors.forename: Athanasios D
authors.initials: AD
authors.lastname: Anastasilakis
authors.affiliation: Academic Orthopaedic Unit, Aristotle University Medical School, Thessaloníki, Greece.
authors.forename: Eustathios
authors.initials: E
authors.lastname: Kenanidis
authors.affiliation: Academic Orthopaedic Unit, Aristotle University Medical School, Thessaloníki, Greece.
authors.forename: Michael
authors.initials: M
authors.lastname: Potoupnis
authors.affiliation: Academic Orthopaedic Unit, Aristotle University Medical School, Thessaloníki, Greece.
authors.forename: Eleftherios
authors.initials: E
authors.lastname: Tsiridis
authors.affiliation: Department of 1st Orthopaedic, 424 General Military Hospital, Thessaloníki, Greece.
authors.forename: Matthaios
authors.initials: M
authors.lastname: Savvidis
authors.affiliation: Department of Radiology, 424 General Military Hospital, Thessaloníki, Greece.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Kartalis
authors.affiliation: Academic Orthopaedic Unit, Aristotle University Medical School, Thessaloníki, Greece.
authors.forename: Fares E
authors.initials: FE
authors.lastname: Sayegh
mesh_terms: D000209:Acute-Phase Proteins / Q000032:analysis*; D000328:Adult; D001416:Back Pain / Q000097:blood / Q000000981:diagnostic imaging; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010384:Pelvic Bones / Q000000981:diagnostic imaging*; D011859:Radiography; D012720:Severity of Illness Index; D012907:Smoking; D013131:Spine / Q000000981:diagnostic imaging*; D013167:Spondylitis, Ankylosing / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging
chemical_list: D000209:Acute-Phase Proteins
keywords: Ankylosing spondylitis; BASDAI; BASFI; Disease activity; Radiographic damage; Smoking