The Relationship Between C-Reaktif Protein/Albumin Ratio and Disease Activity in Axial Spondyloarthritis

Year 2024, Volume: 6 Issue: 1, 33 - 41, 26.02.2024

Nurdan Oruçoğlu , Mustafa Erkut Önder , Fırat Omar

https://doi.org/10.52827/hititmedj.1346698

Abstract

Objective: The C-reactive protein/albumin ratio (CAR) has recently emerged as a novel inflammatory biomarker, indicating its potential role in determining inflammation in various disorders. This study aims to investigate the role of CAO in determining disease activity in axial spondyloarthritis (axSpA).
Materials and Methods: This study is a retrospective case-control study. A total of 128 patients with axSpA and 111 age-gender-matched healthy controls were included in the study. Serum albumin, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) were recorded. CAR was calculated as serum CRP/Albumin. The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and Ankylosing Spondylitis Disease Activity Score-CRP (ASDAS-CRP) scores were used to determine disease activity. Patients were divided into two subgroups based on the ASDAS-CRP score: ≥1.3 was considered active disease, and <1.3 was considered an inactive disease. Additionally, axSpA patients were also subdivided into radiographic and non-radiographic disease groups.
Results: CAR was significantly higher in axSpA patients compared to healthy controls (1.42 (0.91-4.49) and 0.46 (0.25-0.95), p<0.001, respectively). Similarly, CAO was found to be significantly higher in patients with active disease compared to those with inactive disease (4.61 (2.04-6.87) and 0.977 (0.75-1.52), p<0.001, respectively). CAR showed a significant correlation with CRP, ESR, BASDAI, and ASDAS-CRP (r=0.996, p<0.001; r=0.471, p<0.001; r=0.779, p<0.001, r=0.842, p<0.001, respectively). The area under the curve (AUC) for distinguishing active from inactive disease using CAR was 0.795 (95% confidence interval (CI) 0.714-0.861; P<0.001).
Conclusion: CAr correlates highly with disease activity in axSpA. It can potentially be a useful biomarker for determining and monitoring inflammation in axSpA.

Keywords

Axial Spondyloarthritis, inflammation, C-reactive protein, albumin, C-reactive protein/albumin ratio

Project Number

YOK

Aksiyel Spondiloartritte C-Reaktif Protein/Albumin Oranının Hastalık Aktivitesi ile İlişkisi

Abstract

Amaç: C-reaktif protein/albümin oranı (CAO) yakın zamanda yeni bir inflamatuar biyobelirteç olarak tanımlanmış ve inflamasyonun belirlenmesinde birçok hastalıkta potansiyel rolü ortaya konulmuştur. Bu çalışma, aksiyel spondiloartritte (axSpA) hastalık aktivitesinin belirlenmesinde CAO’nun rolünü araştırmayı amaçlamaktadır.
Gereç ve Yöntem: Bu çalışma retrospektif vaka-kontrol çalışmasıdır. Toplam 128 hasta ve 111 yaş-cinsiyet uyumlu sağlıklı kontrol çalışmaya dahil edilmiştir. Serum albumin, C-reaktif protein (CRP), eritrosit sedimantasyon hızı (ESH) kaydedildi. CAO, serum CRP/Albumin şeklinde hesaplanmıştır. Hastalık aktivitesini belirlemek için Bath Ankilozan Spondilit Hastalık Aktivite İndeksi (BASDAI) ve Ankilozan Spondilit Hastalık Aktivite Skoru-CRP (ASDAS-CRP) skorları kullanıldı. Hastalar ASDAS-CRP skoruna göre iki alt gruba ayrıldı: ≥1,3 aktif hastalık, <1,3 inaktif hastalık olarak sınıflandı. Ayrıca axSpA hastaları radyografik ve non-radyografik hastalık olarak da alt gruba ayrıldı.
Bulgular: CAO, axSpA hastalarında sağlıklı kontrollerinden anlamlı şekilde daha yüksekti (Sırasıyla 1,42 (0,91-4,49) ve 0,46 (0,25-0,95), p<0,001). Aktif hastalığı olanlarda da inaktif hastalığa sahip olanlara göre CAO anlamlı derecede daha yüksek bulundu (sırasıyla 4,61 (2,04-6,87) ve 0,977 (0,75-1,52), p < 0,001). CAO, CRP, ESH, BASDAI ve ASDAS-CRP ile anlamlı ölçüde korelasyon göstermekteydi (Sırasıyla r=0,996, p<0,001; r=0,471, p<0,001; r=0,779, p<0,001, r=0,842, p<0,001). CAO’nun aktif hastalığı inaktif hastalıktan ayırt etme gücü için eğri altında kalan alan (EAA) 0,795 (95% güven aralığı (CI) 0.714-0.861; p<0.001) idi.
Sonuç: CAO, axSpA’da hastalık aktivitesi ile iyi derecede korelasyon göstermektedir. AxSpA’nın tanı ve takibinde inflamasyonun potansiyel bir göstergesi olarak kullanılabilecek, yararlı bir biyobelirteç olabilir.

Keywords

C-reaktif protein, Aksiyal Spondiloartrit, albumin, C-reaktif protein/albumin oranı inflamasyon

Supporting Institution

YOK

Project Number

YOK

Thanks

Prof.Dr. Abdullah Canatarolğlu, Dr. Elif Altunel Kılınç, Dr. Gizem Kırmızıer

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