The Role of Prognostic Nutritional Index in Vascular Behçet’s Syndrome

Year 2025, Volume: 7 Issue: 1, 167 - 172, 15.01.2025

Bahar Özdemir Ulusoy , Esra Kayacan Erdoğan , Berkan Armağan , Yüksel Maraş , İsmail Doğan , Kevser Orhan , Serdar Can Güven , Ebru Atalar , Hatice Ecem Konak , Orhan Küçükşahin , Şükran Erten , Ahmet Omma , Hakan Babaoglu

https://doi.org/10.37990/medr.1593728

Abstract

Aim: This study aimed to evaluate the levels of the Prognostic Nutritional Index (PNI) in vascular and non-vascular subtypes of Behçet’s Syndrome (BS) and its potential utility in distinguishing vascular involvement.
Material and Method: This retrospective cohort study included 386 patients diagnosed with BS based on ISG criteria. Patients were categorized into vascular (n=100) and non-vascular (n=286) involvement groups. Subgroup analyses assessed organ-specific patterns of involvement. PNI values were calculated as 10 × serum albumin (g/dL) + 0.005 × total lymphocyte count (/mm3). Statistical analyses were performed to compare PNI levels between subgroups. Additionally, ROC curve analysis was conducted to evaluate the discriminatory ability of PNI for detecting vascular involvement.
Results: Patients with vascular involvement exhibited significantly lower mean PNI values (51.7±6.6) compared to the non-vascular group (56.9±4.4, p<0.001). Neuro-Behçet’s disease was significantly more frequent in the vascular group (19.0%) than in the non-vascular group (2.4%, p<0.001). However, among patients with Neuro-Behçet’s disease without vascular disease, PNI values were found to be similar to the rest of the cohort. ROC analysis demonstrated that PNI effectively differentiated vascular involvement, with an AUC of 0.76, sensitivity of 72.7%, and specificity of 71%. The optimal cutoff value for PNI was determined to be 55.
Conclusion: PNI is a potential marker for identifying vascular involvement in BS. The significantly lower PNI values observed in patients with vascular involvement, coupled with its moderate discriminatory ability, suggest that PNI could serve as a valuable tool in clinical practice. Low PNI values are associated with impaired nutritional and immunological status, which may contribute to or result from the systemic inflammatory burden seen in vascular disease. Further multicenter, prospective studies are warranted to validate these findings.

Keywords

Behçet’s syndrome, vascular involvement, prognostic nutritional index

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