“…To our knowledge, no prior studies have investigated risk factors for the sum score of ASAS HI. Given that ASAS HI was validated to assess health and function in patients with SpA, we only considered the variables that were both shown to be risk factors for function/disability [38][39][40][41][42][43][44][45][46], health status [42], or health-related quality of life [47,48] in previous studies and available in our data as potential confounder. Therefore, potential confounders in the relationships between gender and ASAS HI include disease activity [38,40,45,[47][48][49], mSASSS [45,49], age at the index date [42], disease (symptom) duration [38,42,43,48], smoking history (never, ever/current) [39,43,46], a family history (first degree or secondary degree relatives) of AS [42,43], number of comorbidities (including hypertension, diabetes mellitus, hyperlipidemia, hepatitis B, hepatitis C, gout, coronary artery disease, stroke, periodontal disease, osteoporosis) [43,50], and the presence of any extra-spinal manifestations (i.e., uveitis, psoriasis, inflammatory bowel disease, peripheral arthritis, enthesitis, and dactylitis) [40,50].…”