SAT0379 C-REACTIVE PROTEIN TO ALBUMIN RATIO IS ASSOCIATED WITH DISEASE ACTIVITY IN PATIENTS WITH AXIAL SPONDYLOARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1137.1-1138
Author(s):  
Z. Zhong ◽  
Y. Huang ◽  
Q. Huang ◽  
T. LI
Keyword(s):  
Disease Activity ◽  
Active Group ◽  
Control Group ◽  
C Reactive Protein ◽  
Optimal Cutoff ◽  
Albumin Ratio ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Reactive Protein ◽  
Optimal Cutoff Point

Background:C-reactive protein to albumin ratio (CAR) has emerged as a significant biomarker to evaluate and predict systemic inflammation[1]. However, the role of CAR in patients with axial spondyloarthritis (axSpA) remains unknown.Objectives:The aim of this study was to investigate the relationship between CAR and disease activity of axSpA.Methods:A total of 241 patients and 61 healthy controls from Guangdong Second Provincial General Hospital from December 2015 to August 2019 were retrospectively recruited in this study. Patients were divided into two groups, with 176 patients in remission group (BASDAI<4) and 65 patients in active group (BASDAI≥4). Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), albumin (ALB), CAR, neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and monocyte-lymphocyte ratio (MLR) were detected. The correlations between CAR, NLR, PLR, MLR and disease activity were analyzed by the Spearman’s correlations analysis. Receiver operation characteristic (ROC) curves were performed to evaluate the discriminative utility of these parameters for disease activity of axSpA. Furthermore, the evaluation of the risk factors of axSpA was conducted using binary logistic regression analysis.Results:CAR, ESR, CRP, NLR, PLR and MLR in axSpA patients were significantly higher than those in the control group (p<0.05 for each), while ALB was significantly lower (p<0.001). Similarly, CAR in remission group was higher than that in control group (p<0.001) and was lower than that in active group (p<0.001). Besides, there were significantly positive correlations between CAR and ESR (r=0.702, P<0.001), CRP (r=0.996, P<0.001), BASDAI (r=0.329, p<0.001) and BASFI (r=0.328, P<0.001). Furthermore, ROC suggested that the area under the curve (AUC) of CAR was 0.701, which was the highest. The optimal cutoff point of CAR was 0.3644, with sensitivity and specificity of 58.5% and 79.0%. Logistic analysis results revealed that elevated CAR and MLR were independent risk factors for axSpA (EXP (B) =15.546, 95%CI: 5.898-40.979, P<0.001; EXP (B) =2.206, 95%CI: 1.077-4.519, P=0.031, respectively).Conclusion:CAR was increased in axSpA patients especially in active group, and significantly correlated with disease activity. CAR may serve as a novel inflammatory marker of monitoring disease activity in patients with axSpA.References:[1]He, Y., et al., Correlation between albumin to fibrinogen ratio, C-reactive protein to albumin ratio and Th17 cells in patients with rheumatoid arthritis. Clin Chim Acta, 2020. 500: p. 149-154.Fig 1.ROC curve analysis of the discriminative values of the parameters for disease activity of axSpATable 1.Discriminative values of the parameters for disease activity of axSpAAUC95% CIOptimal cutoff pointSpecificitySensitivityCAR0.7010.623-0.7780.364479.0%58.5%NLR0.4500.365-0.5343.16584.1%18.5%PLR0.5280.448-0.608127.38542.6%69.2%MLR0.4680.384-0.5530.38592.6%16.9%ESR0.6850.612-0.75815.552.3%76.9%CRP0.6910.614-0.76910.8571.6%63.1%CAR, C-reactive protein to albumin ratio; NLR, neutrophil-lymphocyte ratio; PLR, platelet-lymphocyte ratio; MLR, monocyte-lymphocyte ratio; CRP, C reactive protein; ESR, erythrocyte sedimentation rate; AUC, areas under the ROC curveDisclosure of Interests:None declared

scholarly journals Combined score of C-reactive protein level and neutrophil-to-lymphocyte ratio: A novel marker in distinguishing children with exacerbated asthma

2021 ◽  
Vol 35 ◽  
pp. 205873842110406
Author(s):  
Xuming Zhu ◽  
Lina Zhou ◽  
Qingqing Li ◽  
Ruilin Pan ◽  
Jian Zhang ◽  
...  
Keyword(s):  
Neutrophil To Lymphocyte Ratio ◽  
Cutoff Point ◽  
Control Group ◽  
Healthy Children ◽  
C Reactive Protein ◽  
Optimal Cutoff ◽  
Lymphocyte Ratio ◽  
Reactive Protein ◽  
Optimal Cutoff Point ◽  
Asthmatic Group

Background Both C-reactive protein (CRP) level and neutrophil-to-lymphocyte ratio (NLR) are commonly elevated in patients with asthma. It is necessary to develop a novel marker, the combined score of CRP level and NLR (C-NLR score) based on cutoff points of CRP and NLR, and apply it in asthma diagnosis. The aim of this study was to explore whether C-NLR could distinguish children with exacerbated asthma. Methods Children suffering from exacerbated asthma were regarded as the asthmatic group ( n = 86), which was divided into three groups: mild ( n = 54), moderate ( n = 17), and severe ( n = 15). The control group consisted of children without any allergic disease and infection ( n = 38). To compare CRP level and NLR between the asthmatic group and control group, a receiver-operating characteristic curve was constructed to determine area under the curve (AUC) and optimal cutoff point. Thereafter, the C-NLR score was classified as follows: C-NLR score of 2 with an elevated CRP level and high NLR, a C-NLR score of 1 with one of these abnormalities, and a C-NLR score of 0 with a normal CRP level and low NLR. The C-NLR score was then compared among different asthma groups. Results In the control group, the CRP level and NLR were 1.9 (0.5–2.6) mg/L and 1.01 (0.69–1.31), respectively. In the asthmatic group, the CRP level and NLR were 7.3 (3.2–14.2) mg/L and 3.08 (1.73–5.34), respectively, which were higher than those in the control group ( p < 0.001 for CRP and p < 0.001 for NLR). The AUC of CRP was 0.86, and the optimal cutoff point was 3.6 mg/L. The AUC of NLR was 0.86, and the optimal cutoff point was 1.72. The AUC of the C-NLR score was 0.94, and the optimal cutoff point was 1. Conclusions C-NLR, a novel inflammatory marker, was applied here for the exacerbated asthma for the first time. Our study has shown C-NLR is a promising marker to distinguish children with exacerbated asthma from healthy children.

scholarly journals The Relationship between C-Reactive Protein/Albumin Ratio and Disease Activity in Patients with Inflammatory Bowel Disease

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Yi-Han Chen ◽  
Li Wang ◽  
Shu-Yi Feng ◽  
Wei-Min Cai ◽  
Xiao-Fu Chen ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Disease Activity ◽  
Bowel Disease ◽  
Inflammatory Markers ◽  
C Reactive Protein ◽  
Distribution Width ◽  
Albumin Ratio ◽  
Lymphocyte Ratio ◽  
Reactive Protein ◽  
Inflammatory Bowel

Objectives. The aims of this study were to evaluate the C-reactive protein/albumin ratio (CRP/ALB), inflammatory markers, and parameters from the complete blood count (CBC) in patients with inflammatory bowel disease (IBD) and their associations with disease activity. Methods. A total of 876 IBD patients, composed of 275 patients with ulcerative colitis (UC) and 601 patients with Crohn’s disease (CD), were included in this retrospective study, and the serum C-reactive protein (CRP), albumin (ALB), erythrocyte sedimentation rate (ESR), and CBC parameters were measured. To explore the disease activity, the Mayo score and Crohn disease activity index were used to assess UC and CD patients, respectively. Results. The CRP/ALB ratio, CRP, ESR, platelet to lymphocyte ratio (PLR), red blood cell distribution width (RDW), and neutrophil to lymphocyte ratio (NLR) levels in active IBD patients were significantly higher than those in inactive IBD patients, whereas ALB and lymphocyte to monocyte ratio (LMR) levels were significantly decreased (P<0.001). The receiver operating characteristic analysis showed that the optimum cut-off values of the CRP/ALB ratio for active UC and CD were 0.18 and 0.43, with sensitivities of 67.8% and 75.8% and specificities of 86.7% and 92.0%, respectively. Multivariable logistic analysis revealed that after adjusting for these inflammatory markers (ESR, NLR, PLR, and LMR), the CRP/ALB ratio was a statistically significant parameter capable of differentiating the disease activity of UC and CD. Conclusions. This study indicated that the CRP/ALB ratio was closely related to the IBD disease activity. Compared with CBC parameters, the CRP/ALB ratio had a higher discriminative capacity for active IBD.

scholarly journals Neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) may be superior to C-reactive protein (CRP) for predicting the occurrence of differentiated thyroid cancer

2017 ◽  
Vol 51 (3) ◽  
pp. 131-136 ◽  
Author(s):  
S Ozmen ◽  
O Timur ◽  
I Calik ◽  
K Altinkaynak ◽  
E Simsek ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Differentiated Thyroid Cancer ◽  
Control Group ◽  
Tumor Diameter ◽  
C Reactive Protein ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Reactive Protein ◽  
Platelet Lymphocyte Ratio ◽  
Differentiated Thyroid Cancers

AbstractObjectives.NLR (neutrophil-lymphocyte ratio) and PLR (platelet-lymphocyte ratio) are prognostic markers of differentiated thyroid cancers. In our study, we evaluated NLR, PLR and C-reactive protein (CRP) for predicting the occurence of differentiated thyroid cancer. This is the first study that compares NLR and PLR to C-reactive protein indifferantiated thyroid cancer not only papillary cancer but also folliculer cancer.Methods.This study includes 51 papillary carcinoma, 42 papillary microcarcinoma and 31 folliculer carcinoma patients attending to our outpatient Endocrinology Clinic at Erzurum Region Training and Research Hospital between 2009 and 2014. The control group include 50 age, sex and body mass index matched healty subjects. Blood counts and CRP were measured at the day before surgery. Thyroglobulin was measured after 6 months of operation.Results.There were positive correlations between tumor diameter, age, white blood cell (WBC) and thyroglobulin levels. There were also positive correlation between NLR, PLR and CRP levels.Conclusion.In our study, we found out that higher NLR and PLR was associated with higher levels of thyroglobulin which indicates worse survival. CRP levels were also associated with poorer tumor profile but the determining rate was lower according to ROC analysis

scholarly journals Two new inflammatory markers related to the CURB-65 score for disease severity in patients with community-acquired pneumonia: The hypersensitive C-reactive protein to albumin ratio and fibrinogen to albumin ratio

2021 ◽  
Vol 16 (1) ◽  
pp. 84-91
Author(s):  
Bing Luo ◽  
Minjie Sun ◽  
Xingxing Huo ◽  
Yun Wang
Keyword(s):  
Inflammatory Markers ◽  
Characteristic Curve ◽  
Community Acquired Pneumonia ◽  
Low Risk ◽  
Control Group ◽  
C Reactive Protein ◽  
Albumin Ratio ◽  
Lymphocyte Ratio ◽  
Reactive Protein ◽  
The Relationship

Abstract Background The objective of this study was to investigate the relationship among hypersensitive C-reactive protein to albumin ratio (CAR), fibrinogen to albumin ratio (FAR), and the CURB-65 score for community-acquired pneumonia (CAP) severity. Methods Clinical data and laboratory indicators of 82 patients with CAP and 40 healthy subjects were retrospectively analysed. The relationship among CAR, FAR, and the severity of CAP was then analysed. Results CAR and FAR in patients with low-risk CAP were significantly higher than those in the normal control group (P < 0.05). CAR and FAR in patients with medium–high-risk CAP were further increased compared with those in patients with low-risk CAP (P < 0.05). CAR and FAR were positively correlated with hypersensitive C-reactive protein, neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and CURB-65 scores (P < 0.05). In the receiver operating characteristic curve for predicting severe CAP, the area under the curve of combining four biomarkers (CAR + FAR + NLR + PLR) was the largest. CAR was also an independent risk factor for severe CAP (OR = 8.789, 95% CI: 1.543–50.064, P = 0.014). Conclusions CAR and FAR may be used as the inflammatory markers for CAP severity evaluation.

Neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, C-reactive protein to albumin ratio, and albumin to fibrinogen ratio in axial spondyloarthritis: a monocentric study

2020 ◽  
Vol 16 ◽  
Author(s):  
Maroua Slouma ◽  
Safa Rahmouni ◽  
Rim Dhahri ◽  
Imen Gharsallah ◽  
Leila Metoui ◽  
...  
Keyword(s):  
Disease Activity ◽  
Pearson Correlation ◽  
Neutrophil To Lymphocyte Ratio ◽  
High Disease Activity ◽  
C Reactive Protein ◽  
Platelet To Lymphocyte Ratio ◽  
Albumin Ratio ◽  
Lymphocyte Ratio ◽  
Reactive Protein ◽  
Very High

Background: C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) are routinely used to assess disease activity in spondyloarthritis. New biomarkers have been reported, such as neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), CRP to albumin ratio (CAR), and albumin to fibrinogen ratio (AFR). Our study aimed to assess these ratios in spondyloarthritis and to determine the relationship between these ratios and the disease activity. Methods: We conducted a cross-sectional study, including patients with spondyloarthritis. The following ratios were calculated: PLR, NLR, AFR, and CAR. Pearson correlation analysis was carried out to test the correlation of the data. Receiver operating characteristic curves were evaluated for each ratio using ASDASCRP as the gold standard for disease activity. Results: Eighty-five patients were included. The sex ratio was 60 males to 25 females. The mean age was 42.58 ± 11.75 years. There was a positive correlation between the PLR and the following parameters: CAR, CRP, and ESR. A negative correlation was found between AFR and the following ratios: PLR, NLR, CRP, and ESR. The ASDAS correlated negatively with AFR and positively with both PLR and CAR. The cut-offs values of CAR and PLR to distinguish patients with very high disease activity (ASDASCRP>3.5) were 0.442 and 173.64, respectively. Conclusions: Given their good correlation with ESR and CRP, we suggest that PLR, CAR, and AFR can be used as potential indicators of inflammation in spondyloarthritis. The CAR and PLR are useful to identify patients with very high disease activity.

scholarly journals C-REACTIVE PROTEIN/ALBUMIN RATIO AND NEUTROPHIL-LYMPHOCYTE RATIO AS PREDICTORS OF COVID-19 SEVERITY

2021 ◽  
Vol 9 (12) ◽  
pp. 374-378
Author(s):  
M.V. Madhav ◽  
◽  
Y. Sirisha ◽  
V. Anjaneya Prasad ◽  
◽  
...  
Keyword(s):  
Inflammatory Markers ◽  
World Health ◽  
Common Finding ◽  
C Reactive Protein ◽  
Albumin Ratio ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Reactive Protein ◽  
First Case ◽  
Severity Prediction

Coronavirus disease 2019 (COVID-19) was announced in early December 2019. By genome sequencing, the virus was recognised. From Wuhan City, the virus spread globally. The pandemic situation was declared by the World Health Organization.The first case of COVID-19 in Indiawas reported in Kerala on January 27, 2020.The clinical features varied with disease severity. Most COVID-19 patients have non-severe manifestations and show a good prognosis. However, patients with severe disease may progress to pulmonary dysfunction, multiple organ dysfunction, and death. COVID-19 related to a considerable mortality rate in older patients and cases had other morbidities. Studies suggested that the inflammatory storm is a common finding in other coronaviruses.Similarly, increases in the inflammatory markers like C-reactive protein (CRP),ferritin,interleukin-6 (IL-6) and were described in COVID-19 (1). Albumin levels decreased in the inflammatory conditions reduced levels were confirmed in severe COVID-19 patients. Hypoalbuminemia and high CRP/albumin ratio were previously linked to the mortality of various clinical conditions as critically ill patients.To avoid the unnecessary or inappropriate utilisation of the healthcare resources, early prediction of the severity of COVID-19 will be helpful. Severity prediction will also improve the prognosis by reducing the mortality rate.Thus, this study aimed to evaluate the role of inflammatory markers in estimating the severity and predicting the prognosis of COVID-19. This study hypothesised that elevated values of CRP/ albumin ratio and the neutrophil-lymphocyte ratio at the time of COVID-19 diagnosis are associated with COVID-19 severity and mortality.

C-Reactive Protein-to-Albumin Ratio: A Novel Inflammatory Marker and Disease Activity Sign in Early Rheumatoid Arthritis

2021 ◽  
Author(s):  
Mustafa Erkut Onder ◽  
Nurdan Orucoglu ◽  
Firat Omar ◽  
Abdullah Canataroglu
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Early Rheumatoid Arthritis ◽  
Control Group ◽  
C Reactive Protein ◽  
Albumin Ratio ◽  
Reactive Protein ◽  
Early Ra ◽  
Inflammatory Status ◽  
Das 28

Abstract Objective A novel inflammation-based score, C-reactive protein (CRP)-to-albumin ratio (CAR), has been shown to have an association with the inflammatory status in several diseases. We aimed to analyse the association between CAR and disease activity in patients with early rheumatoid arthritis (RA) and to determine the cut-off value of CAR in early and established RA. Methods A total of 177 patients with RA and 111 age and gender-matched healthy controls were included in this study. Cases with a disease duration of less than 1 year were classified as early RA. Serum albumin, CRP, erythrocyte sedimentation rate (ESR), Disease Activity Score-28 (DAS-28-ESR), Clinical Disease Activity Index (CDAI) and Health Assessment Questionnaire (HAQ) scores were recorded. Results CAR was 2.44 (0.21–30.83) in the RA group and 0.45 (0.21–10.47) in the control group (p<0.001). Eighty-seven (49.15%) of the RA cases were classified as early RA. The analyses indicated that the ESR, CRP and CAR values were higher in patients with early RA than in those with established RA and controls. CAR was correlated with albumin, CRP, ESH, DAS-28 and HAQ scores in both early RA and established RA groups. The receiver operating characteristic curves revealed a CAR cut-off value of 2.67 (80% sensitivity and 85% specificity) and 1.63 (77% sensitivity and 72% specificity) for the prediction of early and established RA, respectively. Conclusion CAR, a formulated ratio, has been described as a predictor for disease activity in patients with early RA as well as in those with established RA. However, CAR has higher sensitivity and specificity for early RA than for established RA.

Relationship between C-reactive Protein/Albumin Ratio and Subclinical Inflammation in Patients with Familial Mediterranean Fever

2021 ◽  
Author(s):  
Esra Nagehan Akyol Onder ◽  
Fethi Sirri Cam ◽  
Pelin Ertan
Keyword(s):  
Familial Mediterranean Fever ◽  
Control Group ◽  
Subclinical Inflammation ◽  
Operating Characteristics ◽  
C Reactive Protein ◽  
Distribution Width ◽  
Albumin Ratio ◽  
Lymphocyte Ratio ◽  
Reactive Protein ◽  
Mediterranean Fever

Abstract Background Familial Mediterranean Fever (FMF), which is characterised by recurrent episodes of fever with serositis, is associated with ongoing inflammation without clinical findings during attack-free periods, leading to amyloidosis, the most important complication of FMF. The objective of this study was to investigate the C-reactive protein/albumin ratio (CAR) as a marker to identify subclinical inflammation in symptom-free FMF children and compare the CAR with other systemic inflammatory markers such as mean platelet volume (MPV), red cell distribution width (RDW), neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR). Material and Methods We included 100 patients and 70 healthy subjects. Hospital records were obtained to collect data on laboratory findings and genetic mutations. Results We found that the CAR levels of our FMF patients were significantly higher than those of the control group. We also evaluated that the CAR values had a higher area-under-the-curve value than the other systemic inflammation parameters including CRP, MPV, RDW, NLR, PLR based on Receiver-Operating Characteristics (ROC) analysis. Conclusion It is important to identify subclinical inflammation in FMF patients with simple, reliable, easily accessible markers to avoid amyloidosis. Although the CAR might be used to assess subclinical inflammation in paediatric FMF patients, the prognostic value of CAR is not superior to CRP. Merging CRP and albumin into a single index thus provides no additional benefit in detecting subclinical inflammation in FMF.

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