Bath Ankylosing Spondylitis Metrology Research Articles

Evaluation of periostin and factors associated with new bone formation in ankylosing spondylitis: Periostin may be associated with the Wnt pathway.

Periostin has been shown to be involved in bone anabolism through the regulation of Wnt-β-catenin signaling. It may be one of the pathogenic mechanisms in syndesmophyte formation in ankylosing spondylitis (AS). The aim of this study was to evaluate serum periostin levels in patients with AS and to assess relationships among biomarkers of bone formation and periostin in disease outcomes, particularly radiographic changes. Ninety-seven consecutive AS patients (78% male) and 48 healthy controls (75% male) were included in the study. Serum periostin, dickkopf-1 (DKK-1), sclerostin and vascular endothelial growth factor (VEGF) levels were measured using commercially available enzyme-linked immunosorbent assay kits. Disease-related characteristics of patients were assessed using Ankylosing spondylitis disease activity score - C-reactive protein (ASDAS-CRP), Bath AS Disease Activity Index, Bath AS Functional Index and Bath AS metrology index. Radiographs were scored using the modified New York criteria and modified Stokes AS spinal score (mSASSS). Compared with control subjects, patients with AS had significantly lower serum levels of periostin (P < 0.001) and sclerostin (P < 0.001), but higher serum levels of VEGF (P < 0.001) and high-sensitivity CRP (P < 0.001). Serum periostin (P = 0.005) and sclerostin levels (P = 0.016) were significantly lower in patients with very high disease activity according to ASDAS-CRP. Current age (P = 0.009), age at symptom onset (P = 0.021) and hip joint involvement (P = 0.012) were independently associated with the development of syndesmophyte, in contrast to biomarkers of bone metabolism that we evaluated. Our results suggest that periostin is down-regulated in AS patients with highly active disease and may contribute to disease pathogenesis through an interaction with Wnt signaling.

Cross-cultural adaptation and validation of the Chinese version of the Health Assessment Questionnaire for the Spondyloarthropathies (HAQ-S).

The Health Assessment Questionnaire for Spondyloarthropathies (HAQ-S) is a commonly used questionnaire to evaluate function and health status of patients with ankylosing spondylitis (AS). The objective of this study was to cross-culturally adapt the HAQ-S into Chinese and then to evaluate its reliability and validity. The Chinese version of the HAQ-S was obtained with a five-step procedure of translation and cross-cultural adaptation. All invited patients met the New York criteria for AS, and a total of 103 patients finally participated in this study. Intraclass correlation coefficient (ICC) was used to evaluate the test-retest and inter-rater reliability of the HAQ-S. Internal consistency of the questionnaire was evaluated by Cronbach's alpha coefficient. Spearman's correlation coefficient was calculated to assess the construct validity between the HAQ-S and Bath AS Disease Activity Index (BASDAI), Bath AS Functional Index (BASFI), Bath AS Metrology Index (BASMI), and the laboratory parameters (erythrocyte sedimentation rate, ESR; C-reactive protein, CRP). Test-retest and inter-rater reliability were excellent with intraclass correlation coefficients of 0.987 (p<0.05) and 0.982 (p<0.05), respectively. The overall internal consistency of the HAQ-S was found satisfactory (Cronbach's alpha=0.914). The Chinese version of the HAQ-S correlated good with the BASFI (r=0.749, p<0.01), and moderate with the BASDAI (r=0.581, p<0.01) and the BASMI (r=0.425, p<0.01). But, the adapted questionnaire correlated poorly with ESR (r=0.298, p<0.01) or CRP (r=0.283, p<0.01). The Chinese version of the HAQ-S is reliable and valid for the evaluation of Chinese-speaking patients with AS.

Baseline extent of damage predicts spinal radiographic progression in Korean patients with ankylosing spondylitis treated with golimumab

Background/AimsFor patients with ankylosing spondylitis (AS), golimumab has consistent efficacy in controlling disease activity over 5 years but its benefit in preventing radiographic progression was less clear at 4 years. To predict radiographic progression, we analyzed the baseline characteristics of AS patients in a Korean population.MethodsSixty-eight Korean patients with AS participated in the phase 3, multicenter, randomized, placebo-controlled, double-blind trial (GO-RAISE) which has previously been described. Baseline modified stoke AS spine score (mSASSS) and change in mSASSS from baseline (ΔmSASSS) until week 208 were analyzed in the Korean patients enrolled in the GO-RAISE study.ResultsAlthough Korean patients had lower baseline mSASSS compared to non-Korean patients and received active management, radiographic progression was not prevented. Korean patients who did not undergo radiographic progression of spinal lesions of AS were younger and had shorter symptomatic duration, lower Bath AS functional and metrology indices, better chest expansion, and lower baseline mSASSS. The baseline mSASSS and ΔmSASSS were positively correlated in Korean AS patients (p < 0.001). Radiographic progression was more prevalent (80.0%) when baseline mSASSS > 10 and less common (13.0%) with baseline mSASSS = 0.ConclusionsIn Korean AS patients, radiographic progression of the spine after 4 years was predicted effectively by the initial severity of the spinal lesion(s) in patients treated with golimumab.

Evaluation of the effectiveness of home based or hospital based calisthenic exercises in patients with ankylosing spondylitis.

The aim of this study is to evaluate the effects of calisthenic exercises on functionality, mobility, disaese activity, quality of life, and psychological status in patients with Ankylosing spondylitis (AS). Prospective analysis of forty patients diagnosed with AS were randomized into two exercise groups. AS patients having diagnosis based on 1984-modified New York criteria were involved. Patients were given 8 weeks calisthenic exercise program. Outcome measures including the Bath AS Functional Index (BASFI), Bath AS Disease Activity Index (BASDAI), Bath AS Metrology Index (BASMI), AS Quality of Life Questionnaire (ASQoL), Bath AS Patient Global Score (BAS-G) Hospital Anxiety Depression Score (HADS), erythrocyte sedimentation rate (ESR) and the serum C-reactive protein (CRP) levels were assessed at the baseline and at 8 weeks. Thirty-seven participants completed the exercise programme. After the 8-week exercise programme, the home-based exercise group showed significant improvement in ESR levels and hospital-based exercise group showed significant improvements in terms of the BASMI and HADS-A scores. Calisthenic exercises can be easily performed both at home and in hospital setting. In patients with AS, calisthenic exercises performed at the hospital may improve the mobility, and psychological status (anxiety).

Systematic review of clinical, humanistic, and economic outcome comparisons between radiographic and non-radiographic axial spondyloarthritis.

To evaluate similarities and differences between non-radiographic axial spondyloarthritis (nr-axSpA) and ankylosing spondylitis (AS) with regard to treatment effects and clinical, humanistic, and economic burdens. In this systematic literature review, ACR 2015, EULAR 2015, EMBASE, and PubMed were searched for studies published between January 2010 and September 2015 that compared predefined clinical, humanistic, and economic aspects in nr-axSpA and AS. Publications were processed according to PRISMA guidelines, analyzed according to four research questions, and assessed for the GRADE level of evidence. Of 220 titles screened, 50 studies were evaluable. Treatment effects were reported by 22; clinical, humanistic, and economic burdens were specified by 38, 4, and 0, respectively. Fewer patients with increased C-reactive protein levels, less extensive structural damage, slower radiographic progression, and significantly lower Bath AS Metrology and Bath AS Functional Indices were reported for nr-axSpA than for AS. In contrast, the Bath AS Disease Activity Index, AS Disease Activity Score, and health-related quality of life were similar, indicating comparable clinical and humanistic burdens. Response to conventional therapies and TNFα inhibitors was similar between nr-axSpA and AS patients, although TNFα inhibitors were prescribed less frequently to nr-axSpA patients. Whether nr-axSpA is regarded as an early form of AS or as a distinct disease entity, it represents an important subgroup of axSpA. Ongoing clinical trials may provide the required evidence for a specified indication for TNFα inhibitors, important to prevent off-label use. Further research is crucial to better understand the disease spectrum and predictors of progression.

Musculoskeletal ultrasonographic evaluation of lower limb enthesopathy in ankylosing spondylitis and Behçet’s disease: Relation to clinical status and disease activity

Using clinical and musculoskeletal ultrasonographic (MSUS) examination, we aimed to compare the frequency, pattern, and main sites of peripheral enthesopathies in the lower limbs of ankylosing spondylitis (AS) and Behcet’s disease (BD) patients, and to evaluate their relation with different clinical, laboratory, and functional parameters of both diseases. Fifteen AS patients (group I) and 22 BD patients (group II) were examined clinically and by carrying out MSUS for enthesopathy at five entheseal sites of the lower limbs. A control group of 20 apparently healthy male volunteers was also included. An enthesopathy score was calculated for each patient according to the Glasgow ultrasound enthesitis scoring system (GUESS). Disease activity was assessed using the Bath Ankylosing Spondylitis Disease Activity Index and the Behcet’s disease current activity form in both groups, respectively. The GUESS score was significantly higher (P 0.05), disease duration (P > 0.05), spinal pain scores (P > 0.05), local tenderness scores (P > 0.05), morning stiffness score (P > 0.05), total Bath Ankylosing Spondylitis Disease Activity Index (P > 0.05), Bath AS metrology indices (P > 0.05), AS quality of life scores (P > 0.05), radiographic scores (P > 0.05), erythrocyte sedimentation rate (P > 0.05), and C-reactive protein levels (P > 0.05). In group II, the mean GUESS score was significantly higher (P 0.05) with disease activity. Ultrasonographic changes at the entheseal sites of the lower limbs are prevalent in both AS and BD. These changes are more frequently related to functional and articular involvement. MSUS is more sensitive than clinical examination in detecting enthesopathies of the lower limbs in both AS and BD patients.

Clinical value of Short Form-36 and clinical measures in a prospective cohort study of ankylosing spondylitis patients

To evaluate the clinical value of Short Form-36 (SF-36) questionnaire and the most commonly used clinical measures in a prospective cohort study of ankylosing spondylitis (AS) patients. A total of 517 AS patients were collected from the Department of Rheumatology, Chinese PLA General Hospital from August 2013 to September 2015. The Quality of Life (QoL) was assessed by SF-36 questionnaire and compared with the general population. The correlations between QoL and clinical measures of AS, including the Bath AS disease activity index (BASDAI), Bath AS functional index (BASFI), Bath AS metrology index (BASMI) et al, were analyzed. BASDAI and BASFI were significantly correlated with SF-36 scores (r>0.3, P<0.01). Logistic multiple regression analysis showed that BASDAI, BASFI, BASMI and education had close correlation with the baseline global QoL, physical and mental health. Among these clinical measures, BASDAI variation showed the most important influence on the change of global QoL, physical health and mental health (OR=0.235, 0.209, 0.125; P<0.01). SF-36 can objectively reflect the QoL of patients with AS. Clinical measures such as BASDAI and BASFI show great application value in this prospective cohort study of AS patients.

Musculoskeletal ultrasonographic evaluation of lower limb enthesopathy in ankylosing spondylitis and Behçet’s disease: Relation to clinical status and disease activity

Using clinical and musculoskeletal ultrasonographic (MSUS) examination, we aimed to compare the frequency, pattern, and main sites of peripheral enthesopathies in the lower limbs of ankylosing spondylitis (AS) and Behcet’s disease (BD) patients, and to evaluate their relation with different clinical, laboratory, and functional parameters of both diseases. Fifteen AS patients (group I) and 22 BD patients (group II) were examined clinically and by carrying out MSUS for enthesopathy at five entheseal sites of the lower limbs. A control group of 20 apparently healthy male volunteers was also included. An enthesopathy score was calculated for each patient according to the Glasgow ultrasound enthesitis scoring system (GUESS). Disease activity was assessed using the Bath Ankylosing Spondylitis Disease Activity Index and the Behcet’s disease current activity form in both groups, respectively. The GUESS score was significantly higher (P 0.05), disease duration (P > 0.05), spinal pain scores (P > 0.05), local tenderness scores (P > 0.05), morning stiffness score (P > 0.05), total Bath Ankylosing Spondylitis Disease Activity Index (P > 0.05), Bath AS metrology indices (P > 0.05), AS quality of life scores (P > 0.05), radiographic scores (P > 0.05), erythrocyte sedimentation rate (P > 0.05), and C-reactive protein levels (P > 0.05). In group II, the mean GUESS score was significantly higher (P 0.05) with disease activity. Ultrasonographic changes at the entheseal sites of the lower limbs are prevalent in both AS and BD. These changes are more frequently related to functional and articular involvement. MSUS is more sensitive than clinical examination in detecting enthesopathies of the lower limbs in both AS and BD patients.

Effects of Aerobic Training in Patients with Ankylosing Spondylitis.

To evaluate the effects of aerobic exercise in patients with ankylosing spondylitis (AS). Seventy patients classified with AS by the modified New York criteria were included. The patients were randomly assigned into 2 groups. The intervention group (IG) performed 50 min of walking followed by stretching exercises 3 times a week for 12 weeks. The control group (CG) performed only stretching exercises. The outcome measurements were the Bath indexes [Bath AS Functional Index (BASFI), Bath AS Disease Activity Index (BASDAI), and Bath AS Metrology Index (BASMI)], Health Assessment Questionnaire for the Spondyloarthropathies (HAQ-S), AS Disease Activity Score (ASDAS), the 6-min walk test (6MWT), chest expansion, and the Medical Outcomes Study Short Form-36. Aerobic capacity was assessed by ergospirometry on a treadmill. Routine laboratory techniques were used in determining lipid levels. Assessments were performed immediately before randomization and after 6, 12, and 24 weeks. Thirty-five patients were randomized to the IG and 35 to the CG. There was significant improvement in the BASFI, HAQ-S, BASMI, BASDAI, and ASDAS in both groups (p < 0.05), but did not differ between groups. There was a significant increase in the walking distance in the 6MWT in the IG compared with CG (p < 0.001). The IG showed significant improvement in cardiopulmonary capacity compared with CG. Cholesterol and triglyceride levels did not change in either group. In patients with AS, aerobic training improved walking distance and aerobic capacity. Aerobic training did not provide additional benefits in functional capacity, mobility, disease activity, quality of life, and lipid levels when compared with stretching exercises alone.

Periodontitis Response to Anti-TNF Therapy in Ankylosing Spondylitis.

Recently, it has been demonstrated that patients with ankylosing spondylitis (AS) and rheumatoid arthritis (RA) have a higher risk of periodontitis; however, the effect of anti-TNF therapy in periodontal status of patients with AS and particularly in dental attachment is not known. To evaluate longitudinally the local periodontal effect of TNF-antagonist in AS and compare to patients with RA. Fifteen patients with AS and 15 RA control patients were prospectively evaluated at baseline and after 6 months (6 M) of anti-TNF therapy. Periodontal assessment included: probing pocket depth (PPD), clinical attachment level (CAL), gingival bleeding index, and plaque index. Rheumatologic clinical and laboratory evaluations were the following: Bath AS Disease Activity Index, Bath AS Metrology Index, Bath AS Functional Index, C-reactive protein and erythrocyte sedimentation rate for AS and Disease Activity Score 28 joints, and C-reactive protein and erythrocyte sedimentation rate for patients with RA. At baseline, periodontal parameters were alike in AS and RA (P > 0.05). After 6 M of anti-TNF therapy, clinical and laboratory parameters of rheumatic diseases decreased significantly in the patients with AS and RA (P < 0.05). A significant improvement in periodontal attachment measurements were observed in the patients with AS (PPD, 2.18 vs 1.94 mm; P = 0.02; CAL, 2.29 vs.2.02 mm; P = 0.03), but not in RA (PPD, 1.92 vs 2.06 mm; P = 0.06; CAL, 2.14 vs 2.28 mm; P = 0.27). Oral hygiene and gingival inflammation remained unchanged from baseline to 6-M evaluation in AS and RA (P > 0.05). Patients with AS under anti-TNF improved periodontal attachment. The mechanism for this effect needs further studies.

Psychological effects of calisthenic exercises on neuroinflammatory and rheumatic diseases.

The aim of this study was to evaluate the effects of calisthenic exercises on psychological status in patients with ankylosing spondylitis (AS) and multiple sclerosis (MS). This study comprised 40patients diagnosed with AS randomized into two exercise groups (group1 =hospital-based, group2 = home-based) and 40patients diagnosed with MS randomized into two exercise groups (group1 =hospital-based, group2 =home-based). The exercise programme was completed by 73participants (hospital-based= 34, home-based= 39). Mean age was 33.75 ± 5.77years. After the 8-week exercise programme in the AS group, the home-based exercise group showed significant improvements in erythrocyte sedimentation rates (ESR). The hospital-based exercise group showed significant improvements in terms of the Bath AS Metrology Index (BASMI) and Hospital Anxiety and Depression Scale-Anxiety (HADS-A) scores. After the 8-week exercise programme in the MS group, the home-based and hospital-based exercise groups showed significant improvements in terms of the 10-m walking test, Berg Balance Scale (BBS), HADS-A, and MS international Quality of Life (MusiQoL) scores. There was a significant improvement in the hospital-based and a significant deterioration in the home-based MS patients according to HADS-Depression (HADS-D) score. The positive effects of exercises on neurologic and rheumatic chronic inflammatory processes associated with disability should not be underestimated.

Relationship between physical function, disease activity, spinal mobility and bone parameters (trabecular bone score and bone mineral density) in ankylosing spondylitis patients

This study aimed to evaluate the relationship between physical function, disease activity, spinal mobility and bone parameters in ankylosing spondylitis (AS) patients. Fifty patients (27 men and 23 women) were examined. The clinical assessment included Bath AS Disease Activity Index, AS Disease Activity Score, Bath AS Functional Index, Bath AS Metrology Index (BASMI). Lumbar spine and femoral neck bone mineral density (BMD), spinal trabecular bone score (TBS) and the TBS T-score were calculated by dual-energy X-ray absorptiometry. Prevalence rates for osteoporosis and osteopaenia were 14% and 36%, respectively and for partially and fully degraded microarchitecture – 34% and 16%, respectively. A similar inverse correlation was observed between BASMI and TBS, TBS T-score and femoral BMD bone parameters, which were significantly lower in patients ≥45 years of age. No significant correlations were detected between any bone parameter and indicators of disease activity and physical function. Patients with a disease duration of ≥10 years tended to exhibit either normal or elevated spine BMD. Femoral BMD was lower in men. The higher BASMI was associated with an increased likelihood of TBS < 1.350 (odds ratio (OR) = 1.44, 1.05–1.97, p = 0.024) and TBS T-score < –1.00 (OR = 1.55, 1.11–2.16, p = 0.01). In summary, lumbar spine BMD can be erroneously influenced by osteoproliferation, unlike the TBS and TBS T-score. The limitations in spinal mobility predicted abnormal results for these two TBS parameters. TBS may be a better indicator of bone health than BMD in AS.

Decreased health-related physical fitness in adults with ankylosing spondylitis: a cross-sectional controlled study

Objectives(1) Assess the health-related physical fitness of adults with ankylosing spondylitis (AS) and compare these to the general population, and (2) examine the relationships between physical fitness and condition-specific outcomes. DesignCross-sectional, controlled study. SettingExercise research laboratory. ParticipantsThirty-nine adults with AS (32 men, 7 women) and 39 age- and gender-matched controls. InterventionComprehensive physical fitness assessment, and completion of questionnaires assessing disease activity, physical function and quality-of-life. Main outcome measuresBody composition was assessed by bio-impedance analysis. Flexibility was measured with the Bath AS Metrology Index (BASMI). Cardiorespiratory fitness was assessed by submaximal treadmill test with breath-by-breath gas analysis and heart rate monitoring. Muscular strength and endurance were measured by isokinetic dynamometry of concentric knee flexion/extension. ResultsThe AS group demonstrated significantly lower cardiorespiratory fitness [mean difference −1.3mLmin−1kg−1 (95% CI −1.1 to −1.4)], flexibility [0.4 BASMI units (0.2 to 0.7)], muscular strength [−31.6 peak torque per body weight dominant knee extension (−56.1 to −7.1)], and increased body fat [0.4% (0.0 to 1.2)] compared to population controls (p<.05). There were significant associations between each fitness component and physical function (p<.05). Higher aerobic capacity was significantly associated with improved quality-of-life. Fitness was not significantly associated with disease activity. ConclusionAdults with AS have significantly reduced health-related physical fitness compared to population controls. Decreased body fat, and higher aerobic capacity, muscular fitness and flexibility are significantly associated with improved function. These findings have implications for clinicians assessing adults with AS, and for targeted-exercise prescription in this cohort.

Risk of falls in patients with ankylosing spondylitis.

Risk of vertebral fractures is increased in patients with ankylosing spondylitis (AS). The underlying mechanisms for the elevated fracture risk might be associated with bone and fall-related risks. The aims of this study were to evaluate the risk of falls and to determine the factors that increase the risk of falls in AS patients. Eighty-nine women, 217 men, a total of 306 AS patients with a mean age of 40.1 ± 11.5 years from 9 different centers in Turkey were included in the study. Patients were questioned regarding history of falls within the last 1 year. Their demographics, disease characteristics including Bath AS Disease Activity Index, Bath AS Metrology Index (BASMI), Bath AS Functional Index (BASFI), and risk factors for falls were recorded. The Short Physical Performance Battery (SPPB) test was used for evaluation of static and dynamic balance. Erythrocyte sedimentation rate, C-reactive protein, and 25-hydroxyvitamin D levels were measured. Forty of 306 patients reported at least 1 fall in the recent 1 year. The patients with history of falls had higher mean age and longer disease duration than did nonfallers (P = 0.001). In addition, these patients' BASMI and BASFI values were higher than those of nonfallers (P = 0.002; P = 0.000, respectively). We found that the patients with history of falls had lower SPPB scores (P = 0.000). We also found that the number of falls increased with longer disease duration and older age (R = 0.117 [P = 0.041] and R = 0.160 [P = 0.005]). Our results show that decreased SPPB scores were associated with increased number of falls (R = 0.183, P = 0.006). Statistically significant correlations were found between number of falls and AS-related lost job (R = 0.140, P = 0.014), fear of falling (R = 0.316, P = 0.000), hip involvement (R = 0.112, P = 0.05), BASMI (R =0.234, P = 0.000), and BASFI (R = 0.244, P = 0.000). Assessment of pain, stiffness, fatigue, and lower-extremity involvement as well as asking for a history of falls will highlight those at high risk for further falls. In addition to the general exercise program adopted for all patients, we suggest that a balance rehabilitation program should be valuable for the patients with risk factors for fall. Exercise may improve fear of falling and BASFI and BASMI scores. However, further study is needed to investigate these hypotheses. We believe that clinicians should train and support the patients via reducing fear of falls and maintaining good posture and functional capacity.

Elevated Serum Levels of Calprotectin (Myeloid-Related Protein 8/14) in Patients With Ankylosing Spondylitis and Its Association With Disease Activity and Quality of Life

BackgroundCalprotectin is one of the major leukocyte S100 proteins showing both calcium binding and antimicrobial characteristics. The serum level of calprotectin is markedly elevated in patients with inflammatory bowel disease,...

AB0735 Diagnostic Delay Worsens Mobility and Work Disability in Ankylosing Spondylitis

BackgroundDiagnostic delay (DD) in Ankylosing Spondylitis (AS) remains a challenge, averaging 8.6 years1. Chronic back pain comprises 2.6million GP consultations per year, of which 5% have AS2. Identifying this “needle...

AB0951 Preclinical Atherosclerosis in Patients with Ankylosing Spondylitis without Clinically Evident Cardiovascular Disease

BackgroundAnkylosing spondylitis is a chronic sistemic inflammatory sistemic disease. An increase in cardiovascular mortality and morbidity is reported in ankylosing spondylitis (AS). However, the association between atherosclerosis and AS is...

AB0952 Subclinical Left Ventricular Dysfunction in Patients with Ankylosing Spondylitis without Clinically Evident Cardiovascular Disease: A Two-Dimensional Speckle Tracking Echocardiographic Study

BackgroundCardiac involvement is common in ankylosing spondylitis (AS), which has not been previously evaluated by using speckle tracking echocardiography (STE).ObjectivesThe objectives of this study were to evaluate the left ventricle...

AB0659 Predictors for Metrological Outcome in Ankylosing Spondylitis after Treatment with Tumor Necrosis Factor Inhibitors

BackgroundTumor necrosis factor (TNF) inhibitors provide effective therapeutic benefit in reducing clinical symptoms of ankylosing spondylitis (AS), especially in the amelioration of spinal inflammation. Metrological measures represent a clinically useful...

Visceral fat reflects disease activity in patients with ankylosing spondylitis.

Response to infliximab treatment diminishes as body mass index (BMI) increases in patients with ankylosing spondylitis (AS). The purpose of the study was to determine if diminished response to infliximab treatment in patients with AS could be associated with increased visceral adipose tissue rather than increased BMI. Twenty six AS patients (21 males and five females) who fulfilled the modified New York criteria and who were currently receiving infliximab treatment were enrolled in the study. Pain was measured by the visual analogue scale (VAS). The disease activity and functional status were assessed by the Bath AS Disease Activity Index (BASDAI) and the Bath AS Functional Index (BASFI). The Bath AS Metrology Index (BASMI) was used to evaluate mobility restrictions. Weight and visceral body composition were measured without shoes in light indoor clothes using a bio-impedance meter. There was a significant correlation between visceral adipose tissue amount and disease activity under infliximab treatment. In correlation analysis, visceral fat showed significant correlations between BASDAI (r=0.545, p=0.004) and VAS (r=0.458, p=0.019). Total body fat also showed a significant correlation with BASDAI (r=0.463, p=0.017). A significant correlation was found between visceral adipose tissue amount and disease activity in patients with AS.