The Frequency of Atopic Diseases and Metabolic Conditions in Patients with Ankylosing Spondylitis: A Cross-Sectional Clinical Trial with a Review of Literature

Abstract

Abstract Introduction The immunological paradigm Th1/Th2 predicts a negative association between autoimmune (Th1) and atopic (Th2) diseases. In contrast to the Th1/Th2 paradigm, some of the latest evidence suggests the probability of coexistence of autoimmune diseases with atopic disorders. Therefore, this trial aims to investigate the frequency of atopic disorders and metabolic conditions in patients with AS and compare them with those in control groups. Materials and methods A total of 563 AS patients (group 1) were matched in a 1:1 ratio with patients suffering from chronic low back pain due to intervertebral disc prolapse (group 2) utilizing gender and age as paired variables. Atopic diseases such as atopic dermatitis (AD), allergic rhinitis (AR) and asthma were investigated in all groups. Also, metabolic conditions such as hypertension (HT), diabetes mellitus (DM), hyperlipidaemia (HPL) and hypothyroidism (HPT) were examined in all groups. Results The mean age was 42.86±11.04 years in both study groups. In all groups, 47.1% were female and 52.9% were male. The mean duration of disease was 10.51±8.93 years in the AS group. HLA-B27 was positive in 70.2% of the patients in the AS group. The adjusted odds ratios for patients with AS compared to controls were 1.47 (1.20–1.80) for AD, 1.76 (1.60–1.95) for AR, and 1.79 (1.57–2.05) for asthma. The adjusted odds ratios for patients with AS compared to controls were 1.09 (95% CI 0.87–1.38) for HT, 1.03 (95% CI 0.76–1.39) for DM, 1.22 (95% CI 0.80–1.87) for HPL, and 1.62 (95% CI 1.04–2.54) for HPT. There was a statistically significant distinction between groups, and the frequency of AD, AR, asthma and HPT was higher in patients with AS compared with the control group (p<0.05). Conclusion According to the findings of this study, which are compatible with the literature, patients with AS have an increased frequency of atopic diseases as well as hypothyroidism. The tissue injury resulting from chronic inflammation in AS patients could be related to atopic disorders and hypothyroidism. In other words, the pathogenic pathways causing chronic inflammation in these diseases may interfere with each other.