scholarly journals Predictive value of C-Reactive Protein/Albumin ratio in patients with chronic complicated diabetes mellitus

2019 ◽  
Vol 35 (6) ◽  
Author(s):  
Muharrem Bayrak

Objective: To investigate the relationship between serum C-reactive protein (CRP)/albumin (ALB) ratio and complication occurrence in patients with Type-II diabetes mellitus with at least one chronic complication. Methods: The CAR, demographic characteristics, and other parameters of 108 patients with at least one chronic diabetic complication who attended to the internal medicine outpatient clinic between January 1, 2017, and September 1, 2018, were retrospectively evaluated. Healthy control subjects who did not have any systemic or infectious diseases were also included in the study. I compared the CAR, demographics, and other blood parameters between the two groups were compared. Results: The mean CAR levels were significantly higher in diabetic patients with at least one complication compared to the control group (0.15 [0.07 - 0.29] vs 0.07 [0.07 - 0.07], respectively, p<0.001). There was no significant correlation between CAR and diabetic complications, including neuropathy, nephropathy, coronary artery disease, and retinopathy in the patient group (p>0.05 for all). In the receiver operating curve (ROC) analysis, there was no significant cut-off point for CAR predicting diabetic complications. Conclusions: Although serum CAR levels were significantly higher in complicated diabetic patients compared to controls, any validated CAR value for predicting diabetic complications were not observed. doi: https://doi.org/10.12669/pjms.35.6.618 How to cite this:Bayrak M. Predictive value of C-Reactive Protein/Albumin ratio in patients with chronic complicated diabetes mellitus. Pak J Med Sci. 2019;35(6):1616-1621. doi: https://doi.org/10.12669/pjms.35.6.618 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Hayrunnisa Bekis Bozkurt

Abstract Objectives To investigate the relationship between the ratios of C-reactive protein (CRP)/albumin, neutrophil/lymphocyte (NLR), monocyte/lymphocyte (MLR), mean platelet volume (MPV)/platelet and erythrocyte sedimentation rate (ESR)/albumin in pediatric patients diagnosed with community-acquired pneumonia based on the severity of the disease. Methods This retrospective cross-sectional study included 52 patients with mild pneumonia, 30 with severe pneumonia, and 46 healthy controls. Whole blood parameters, CRP, ESR, and albumin values and ratios were recorded at the time of admission. The multivariate regression analysis, Pearson’s correlation and ROC curve analyses were performed. Results The CRP/albumin, ESR/albumin, NLR and CRP values were significantly higher in the severe pneumonia group compared to both the other pneumonia group and the control group (p<0.005). According to the regression and correlation analyses, these values were positively correlated (p<0.001). For CRP/Albumin ratio, ESR/albumin ratio calculated OR were 2.103 (CI: 1.675–2.639); 1.907 (CI: 1.552–2.344); respectively. Conclusions The data presented can be a guide in the follow-up and treatment of this patient group.


Author(s):  
Brigitte Rina Aninda Sidharta ◽  
JB. Suparyatmo ◽  
Avanti Fitri Astuti

Invasive Fungal Infections (IFIs) can cause serious problems in cancer patients and may result in high morbidity andmortality. C-reactive protein levels increase in response to injury, infection, and inflammation. C-reactive protein increasesin bacterial infections (mean of 32 mg/L) and in fungal infections (mean of 9 mg/L). This study aimed to determineC-Reactive Protein (CRP) as a marker of fungal infections in patients with acute leukemia by establishing cut-off values ofCRP. This study was an observational analytical study with a cross-sectional approach and was carried out at the Departmentof Clinical Pathology and Microbiology of Dr. Moewardi Hospital in Surakarta from May until August 2019. The inclusioncriteria were patients with acute leukemia who were willing to participate in this study, while exclusion criteria were patientswith liver disease. There were 61 samples consisting of 30 male and 31 female patients with ages ranging from 1 to 70 years.Fifty-four patients (88.5%) were diagnosed with Acute Lymphoblastic Leukemia (ALL) and 30 (49.18%) were in themaintenance phase. The risk factors found in those patients were neutropenia 50-1500 μL (23.8%), use of intravenous line(22%), and corticosteroid therapy for more than one week (20.9%). The median of CRP in the group of patients with positiveculture results was 11.20 mg/L (11.20-26.23 mg/L) and negative culture results in 0.38 mg/L (0.01-18.63 mg/L). The cut-offvalue of CRP using the Receiver Operating Curve (ROC) was 9.54 mg/L (area under curve 0.996 and p. 0.026), with a sensitivityof 100%, specificity of 93.2%, Positive Predictive Value (PPV) of 33.3%, Negative Predictive Value (PPV) of 100%, PositiveLikelihood Ratio (PLR) of 1.08, Negative Likelihood Ratio (NLR) of 0 and accuracy of 93.4%. C-reactive protein can be used asa screening marker for fungal infections in patients with acute leukemia.


2014 ◽  
Vol 21 (06) ◽  
pp. 1174-1177
Author(s):  
Mukhtiar Hussain Jaffery ◽  
Nisar Ahmed Shah ◽  
Muhammad Sajid Abbas Jaffri ◽  
Athar Hussain Memon ◽  
Syed Zulfiquar Ali Shah

Objective: To determine the frequency of raised C-reactive protein (CRP) in patients with type 2 diabetes mellitus. Patients and methods: This cross sectional descriptive study of six months study was conducted at Liaquat University Hospital Hyderabad from March 2013 to August 2013. All diabetic patients of ≥35 years age of either gender for >01 year duration visited at OPD were evaluated for C-reactive protein and their glycemic status by hemoglobin A1c. The data was analyzed in SPSS and the frequency and percentage was calculated. Results: During six month study period, total 100 diabetic patients were evaluated for C-reactive protein. Majority of patients were from urban areas 75/100 (75%). The mean ±SD for age of patients with diabetes mellitus was 51.63±7.82. The mean age ±SD of patient with raised CRP was 53±7.21. The mean ±SD for HbA1c in patients with raised CRP is 9.55±1.73. The mean random blood sugar level in patients with raised CRP was 247.42 ± 6.62. The majority of subjects from 50-69 years of age group with female predominance (p = 0.01) while the CRP was raised in 70(70%) patients in relation to age (p=0.02) and gender (p=0.01) respectively. Both HbA1c and CRP was raised in 64.9% (p = 0.04) in patients with type 2 diabetes mellitus. The mean ±SD of CRP was 5.8±1.21 while for male and female individuals with raised CRP was 3.52±1.22 and 5.7±1.63 respectively. Conclusions: The raised CRP was observed in patients with type 2 diabetes mellitus


Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Nikolaos Gouliopoulos ◽  
Gerasimos Siasos ◽  
Marilita Moschos ◽  
Dimitrios Tousoulis ◽  
Evangelos Oikonomou ◽  
...  

Introduction: Diabetic Retinopathy (DR) is a complication of diabetes mellitus (DM) leading to deterioration of vision. Hypothesis: We investigated the possible association of vascular function and inflammation with visual acuity in subjects with DM. Methods: We enrolled 100 consecutive subjects with DM. Patients were divided in those with DR (53 subjects, mean age 68±9) and those with no evidence of DR (NDR) (mean age 66±6). The diagnosis of DR was made by ophthalmoscopy and best-corrected visual acuity (BCVA) was measured in both eyes. A BCVA less than 0.8 was considered as severely impaired. Endothelial function was evaluated by flow mediated dilation (FMD) in the brachial artery and arterial stiffness was evaluated by carotid femoral pulse wave velocity (PWV). C reactive protein (CRP) and interleukin 6 (IL6) levels were measured. Results: Patients with DR compared to NDR patients had impaired FMD (3.42±1.08% vs. 5.39±1.47%, p<0.001), impaired PWV (11.10±3.11m/sec vs. 9.02±2.13m/sec, p=0.001) and worse BCVA (p<0.001). Moreover in DM subjects, BCVA was positively correlated with FMD, creatinine clearance, and inversely correlated with PWV, glycosylated hemoglobin levels, C- reactive protein levels, IL6 levels, age and with duration of diabetes mellitus (p<0.01 for all). Interestingly, after adjustment for age, smoking habits and the aforementioned confounders, FMD, IL6 levels, DM duration and male gender were independently associated with BCVA (p<0.05 for all). Moreover, ROC curve analysis revealed that both impaired FMD (AUC=0.79, p<0.001) and PWV (AUC=0.8, p<0.001) have a significant diagnostic ability in detecting diabetic subjects with severely impaired BCVA. More precisely, FMD less than 4.5% has a sensitivity of 90% and a specificity of 60%, while PWV over 10.0 m/sec has a sensitivity of 83% and a specificity of 68%, for the diagnosis of severely impaired BCVA. Conclusion: Patients with DR have significantly impaired visual acuity witch is associated with impaired vascular function and inflammation. Moreover, both endothelial function and arterial stiffness were high sensitivity predictors of visual impairment highlighting their potential role on the prevention and management of the complications in diabetes mellitus.


2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1137.1-1138
Author(s):  
Z. Zhong ◽  
Y. Huang ◽  
Q. Huang ◽  
T. LI

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


Author(s):  
Amika Aggarwal ◽  
Sangeeta Pahwa

Background: Preterm birth is one of the most important cause of perinatal morbidity and mortality. PROM is defined as spontaneous rupture of membranes before the onset of uterine contraction. Objective of present study was to evaluate the role of CRP as an early predictor of Chorioamnionitis in PPROM.Methods: A prospective study was done on 50 cases with PPROM and 50cases of control group without PPROM. All mothers and babies were observed from the time of admission to the time of discharge.Results: C-reactive protein appears to be the most sensitive acute phase protein; rising of less than 24 hours makes it suitable to serve as a marker for diagnosing an infective process in early stage. On comparing C-reactive protein levels with other laboratory tests and indicators of infection (e.g. total leucocyte count DLC, maternal fever, maternal tachycardia, fetal tachycardia) we found CRP level to be more sensitive (100%) but less specific (69.56%) in identifying clinical Chorioamnionitis. The positive predictive value was 22.22% and negative predictive value was 100%.Conclusions: In cases of PPROM, raised CRP is an early predictor of clinical Chorioamnionitis as well as histological Chorioamnionitis.


2018 ◽  
Vol 13 (1) ◽  
pp. 456-462
Author(s):  
Qiang Guo ◽  
Chuanqin Xu ◽  
Chao Sun ◽  
Yubao Zhao ◽  
Weifu Zhang

AbstractThe timely and accurate diagnosis of ascites is of great significance for early treatment and prognostication. This study explored the value of soluble myeloid triggering receptor expressed on myeloid cell 1 (sTREM-1) and C-reactive protein (CRP) for assessing ascites. A total of 133 patients with ascites who received treatment at the Affiliated Hospital of Taishan Medical University between September 2015 and September 2017 were retrospectively analyzed. The ascites in 22, 45, 33 and 33 patients were tuberculous, bacterial, tumorous, and transudative, respectively. Healthy volunteers (n=30) who received a health examination at the same hospital during the same period constituted the control group. Before treatment, both ascitic sTREM-1 and CRP showed significant differences among the ascites subgroups (P<0.001), with the highest levels in the bacterial subgroup. Serum sTREM-1 and CRP also showed significant differences among the groups. A correlation analysis showed a positive correlation between sTREM-1 and CRP. ROC curves of the bacterial subgroup showed that when the optimal cutoff point was set to 20.2, the sensitivity, specificity, positive predictive value, and negative predictive value of the serum sTREM-1 index were 0.933, 0.955, 0.914, and 0.965, respectively. sTREM-1 may provide more diagnostic value than CRP for the diagnosis of bacterial ascites.


2021 ◽  
Author(s):  
Seyedreza Mirsoleymani ◽  
Erfan Taherifard ◽  
Ehsan Taherifard ◽  
Mohammad Hossein Taghrir ◽  
Milad Ahmadi Marzaleh ◽  
...  

Late in 2019, the first case of COVID-19 was detected in China, and the disease caused a pandemic state worldwide. Up to now, many studies have investigated the impact of comorbid diseases, especially diabetes mellitus, on COVID-19 outcomes. In this study, we aimed to assess the para-clinic characteristics of COVID-19 patients with or without diabetes mellitus to identify factors indicative of poor prognoses. In this prospective study, 153 in-patients with COVID-19 were followed up from 1 March to 19 April. Paraclinical information of these patients was gathered from their medical records. Afterward, the association between these factors among both diabetic and non-diabetic patients was assessed in the correlation analyses. Discharge and expiration of 77.1% and 22.9% of the study participants resulted in a 1063 person-day follow-up for patients who were discharged healthily and 384 person-day follow-ups for expired patients. 41.8% of the participants had diabetes mellitus. Lymphocytopenia and Neutrolhilia prevalences increased during hospitalization; comparing with their initial prevalences. Thirty-seven patients got acute respiratory distress syndrome; of those, 35 died. The mean of the initial C reactive protein level was 42.49, and serum creatinine of 1.39. The study showed that higher initial neutrophil count, increasing neutrophil count more than 15000 and decreasing lymphocyte count below 1000 during hospitalization; development of acute respiratory distress syndrome and being intubated; initial C reactive protein and serum creatinine level were associated with higher mortality rates in COVID-19 victims.


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