| Objective To observe the effect of adalimumab on the bone metabolism indexes in patients with ankylosing spondylitis (AS). Methods Forty-two patients with active ankylosing spondylitis in the rheumatology department of Changhai Hospital from January 2014 to December 2017 were randomly selected, and 42 normal people were used as control group. All AS patients were treated with adalimumab 40mg per 2 weeks for 24 weeks. Bone mineral density of the lumbar vertebrae and hip was detected with DXA. An electrochemiluminescence was used to detect the serum bone metabolism indexes, including β-collagen degradation products (β-CTX), total 1 collagen amino end lengthening peptide (P1NP), osteocalcin N terminal molecular fragment (N-MID), 25 hydroxyvitamin D, and parathyroid hormone (PTH). The incidence of osteoporosis in AS patients, bone metabolism indexes between the AS group and the normal control group, as well as the degree of activity of the disease and the index of serum bone metabolism after adalimumab treatment in the patients with AS were evaluated. Results The incidence of osteoporosis in 42 active AS patients was 13.6%, the incidence of osteopenia was 25.8%, and the bone mass was normal in 60.6%. Compared with the normal control group, the levels of β-CTX, P1NP, N-MID, and PTH were significantly higher in AS patients (P < 0.01), and the level of 25 hydroxyvitamin D decreased significantly (P < 0.01). After adalimumab treatment for 24 weeks, the clinical symptoms and laboratory indexes in AS patients improved obviously, the levels of bone metabolic markers, β-CTX, P1NP, N-MID, and PTH decreased significantly (P < 0.01), and the level of 25 hydroxyvitamin D increased significantly (P < 0.01). There was no obvious change in serum Ca and P levels. Conclusion Bone metabolism disorders and active bone formation and bone destruction occur in AS patients. Adalimumab not only releases the activity of AS disease, but also improves bone metabolism in AS patients. |