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Demographic, clinical, laboratory, and dual-energy X-ray absorptiometry (DXA) data were collected. AS disease activity was assessed using Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Serum TRACP5b was measured by ELIZA. Group differences, correlations, and ROC curve analysis were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      AS patients were predominantly male and younger than OP patients. Primary OP patients had significantly lower DXA T-scores than AS patients (mean difference\u2009=\u20092.36,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). TRACP5b levels were higher in AS patients than controls but not significantly different (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.111). In AS, TRACP5b correlated with age (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.534,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.009) and disease activity (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.427,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.042) but not with BMD. ROC analysis showed moderate diagnostic performance for detecting secondary osteoporosis in AS (AUC\u2009=\u20090.653). No significant differences in TRACP5b or BMD were found across AS treatment groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Serum TRACP5b may serve as a supplementary marker of osteoclast activity in AS and shows moderate diagnostic value for secondary osteoporosis, with levels more related to age and disease activity than BMD. Larger studies are needed to confirm its clinical utility.\n                      <jats:table-wrap>\n                        <jats:table>\n                          <jats:tbody>\n                            <jats:tr>\n                              <jats:td colspan=\"2\">\n                                <jats:bold>Key Points<\/jats:bold>\n                                \u2022\n                                <jats:italic>Serum TRACP5b levels were higher in patients with AS than in healthy controls, though without consistent statistical significance, reflecting biological variability.<\/jats:italic>\n                                \u2022\n                                <jats:italic>TRACP5b correlated positively with age and disease activity (BASDAI) in AS but not with BMD, disease duration, or ESR, highlighting its link to inflammatory bone resorption.<\/jats:italic>\n                                \u2022\n                                <jats:italic>ROC analysis showed TRACP5b had moderate diagnostic performance for secondary osteoporosis in AS, but limited value in primary osteoporosis.<\/jats:italic>\n                                \u2022\n                                <jats:italic>Our findings suggest that TRACP5b may serve as supplementary marker of bone turnover in AS, warranting further validation in larger, longitudinal studies.<\/jats:italic>\n                              <\/jats:td>\n                            <\/jats:tr>\n                          <\/jats:tbody>\n                        <\/jats:table>\n                      <\/jats:table-wrap>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10067-026-07966-7","type":"journal-article","created":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T01:34:13Z","timestamp":1771292053000},"page":"2277-2285","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Diagnostic utility of serum TRACP5b for secondary osteoporosis in ankylosing spondylitis: a comparative cross-sectional study with primary osteoporosis and healthy controls"],"prefix":"10.1007","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6299-5144","authenticated-orcid":false,"given":"Doaa","family":"Kamal","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5940-0007","authenticated-orcid":false,"given":"Nihal","family":"Fathi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Asmaa Osama B. 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