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Purpose: To investigate whether serum amyloid A (SAA) levels are increased in patients with ankylosing spondylitis (AS) and whether its levels correlate well with AS disease activity. Materials and Methods: Thirty-eight patients with AS and 38 age- and sex-matched control subjects were enrolled in this cross-sectional study. Their SAA levels were quantitatively measured by immunonephelometry. An established, self-administered instrument for evaluating disease activity (Bath Ankylosing Spondylitis Disease Activity Index, BASDAI) was used to measure and acute phase reactants, including erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), in patients with AS. Results: Patients with AS had a significantly higher mean SAA level than controls (9.52±7.49mg/L versus 2.73±1.57mg/L, p<0.05), and the mean BASDAI score of patients with elevated SAA levels was significantly higher than that of patients with normal SAA levels (5.6±1.3 versus 4.4±1.5, p<0.05). SAA levels showed significant correlations with BASDAI scores (r=0.431, p=0.007), ESR (r=0.521, p=0.001) and CRP levels (r=0.648, p<0.001). Additionally, the correlation between ESR and CRP levels also appeared significant (r=0.703, p< 0.001). In those with normal ESR or CRP levels, SAA levels and BASDAI scores were elevated (p<0.05) and showed a trend of positive correlation with one another. Conclusion: Our data showed that SAA levels were increased in patients with AS and correlated well with disease activity. These findings suggest that SAA can be used as a valuable indicator of disease activity in AS.