Öz
Objective: The C-reactive protein (CRP)-albumin (ALB) ratio (CAR) has emerged as a novel inflammatory biomarker. The aim of this study was to evaluate the clinical significance of CAR in psoriatic arthritis (PsA) patients.
Materials and Methods: The study included 76 PsA patients and 48 healthy controls. After obtaining informed consent from the patients and controls, demographic information, clinical and laboratory findings at admission, neutrophil/lymphocyte ratio (NLR), monocyte/lymphocyte ratio (MLR), platelet/lymphocyte ratio (PLR) and C-reactive protein/albumin (CAR) were recorded. The PASI score, a PsA-specific measure of skin involvement, and the number of swollen-tender joints were used as measures of disease activity in PsA. The correlation between CAR and markers of disease activity (number of swollen-tender joints, PASI) and traditional acute phase reactants [erythrocyte sedimentation rate (ESR), C-reactive protein (CRP)] were analyzed.
Results: CAR was significantly higher in PsA patients than in the healthy group (p<0.001). PLR, CAR, MLR, ESR and CRP values were statistically significantly higher in the patient group compared to the control group (p<0.001, except ESR, P=0.007, respectively). There was a statistically significant association between CAR and PLR, MLR, ESR, CRP values and number of swollen-tender joints in PsA patients. ROC curve analysis showed that the area under the curve (AUC) of CAR for the PsA group was 0.701. When the CAR optimal cut-off point ≥0.76 was accepted, the sensitivity level was 64.5% and the specificity level was 64.6%.
Conclusion: CAR may be useful in daily practice as a simple and rapid assessment method to evaluate inflammation in PsA.
Anahtar Kelimeler
Kaynakça
- 1. Calabresi E, Monti S, Governato G, et al. One year in review 2018: psoriatic arthritis. Clin Exp Rheumatol. 2019;37(2):167-178.
- 2. Menon B, Gullick NJ, Walter GJ, et al. Interleukin-17+CD8+ T cells are enriched in the joints of patients with psoriatic arthritis and correlate with disease activity and joint damage progression. Arthritis Rheumatol. 2014;66(5):1272-1281.
- 3. M. Dougados, A. Gueguen, J. P. Nakache et al., “Clinical relevance of C-reactive protein in axial involvement of ankylosing spondylitis,” The Journal of Rheumatology, vol. 26, no. 4, pp. 971–974, 1999.
- 4. Zhong Z, Huang Y, Liu Y, et al. Correlation between C-Reactive Protein to Albumin Ratio and Disease Activity in Patients with Axial Spondyloarthritis. Dis Markers. 2021;2021:6642486.
- 5. Kim DS, Shin D, Lee MS, et al. Assessments of neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in Korean patients with psoriasis vulgaris and psoriatic arthritis. J Dermatol. 2016;43(3):305-310.
- 6. Asahina A, Kubo N, Umezawa Y, Honda H, Yanaba K, Nakagawa H. Neutrophil-lymphocyte ratio, platelet-lymphocyte ratio and mean platelet volume in Japanese patients with psoriasis and psoriatic arthritis: Response to therapy with biologics. J Dermatol. 2017;44(10):1112-1121.
- 7. An, I., Ucmak, D., Ozturk, M., Aksoy, M., Yildiz, I., & Ucan, E. (2021). Neutrophil / Iymphocyte ratio, platelet / Iymphocyte ratio, mean platelet volume and C-reactive protein values in psoriatic arthritis patients . Annals of Medical Research, 26(5), 0894–0898.
- 8. Sunar İ, Ataman Ş. Serum C-Reactive Protein/Albumin Ratio in Rheumatoid Arthritis and its Relationship With Disease Activity, Physical Function, and Quality of Life. Arch Rheumatol. 2020;35(2):247-253.
- 9. Afifi N, M Medhat B, Abdel Ghani AM, Mohamed Ali Hassan HGE, Behiry ME. Value of Albumin-Fibrinogen Ratio and CRP-Albumin Ratio as Predictor Marker of Disease Activity in Egyptian RA Patients, Correlated with Musculoskeletal Sonography. Open Access Rheumatol. 2020;12:241-248.
- 10. Hocanlı İ. , Kabak M. CLINICAL IMPORTANCE OF C-REACTIVE PROTEIN TO ALBUMIN RATIO (CAR) IN COVID-19 PNEUMONIA. J Contemp Med. 2022; 12(2): 266-270.
- 11. Taylor W, Gladman D, Helliwell P, et al. Classification criteria for psoriatic arthritis: development of new criteria from a large international study. Arthritis Rheum. 2006;54(8):2665-2673
- 12. Mease PJ. Measures of psoriatic arthritis: Tender and Swollen Joint Assessment, Psoriasis Area and Severity Index (PASI), Nail Psoriasis Severity Index (NAPSI), Modified Nail Psoriasis Severity Index (mNAPSI), Mander/Newcastle Enthesitis Index (MEI), Leeds Enthesitis Index (LEI), Spondyloarthritis Research Consortium of Canada (SPARCC), Maastricht Ankylosing Spondylitis Enthesis Score (MASES), Leeds Dactylitis Index (LDI), Patient Global for Psoriatic Arthritis, Dermatology Life Quality Index (DLQI), Psoriatic Arthritis Quality of Life (PsAQOL), Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F), Psoriatic Arthritis Response Criteria (PsARC), Psoriatic Arthritis Joint Activity Index (PsAJAI), Disease Activity in Psoriatic Arthritis (DAPSA), and Composite Psoriatic Disease Activity Index (CPDAI). Arthritis Care Res (Hoboken). 2011;63 Suppl 11:S64-S85.
- 13. Guo Y, Cai K, Mao S, et al. Preoperative C-reactive protein/albumin ratio is a significant predictor of survival in bladder cancer patients after radical cystectomy: a retrospective study. Cancer Manag Res. 2018;10:4789-4804.
- 14. Qin G, Tu J, Liu L, Luo L, Wu J, Tao L, et al. Serum albumin and c-reactive protein/albumin ratio are useful biomarkers of Crohn’s disease activity. Med Sci Monit 2016;22:4393-4400.
- 15. Moon JS, Ahn SS, Park YB, Lee SK, Lee SW. C-Reactive Protein to Serum Albumin Ratio Is an Independent Predictor of All-Cause Mortality in Patients with ANCA-Associated Vasculitis. Yonsei Med J 2018;59:865-71.
- 16. Bruschi M, Candiano G, Santucci L, Ghiggeri GM. Oxidized albumin. The long way of a protein of uncertain function. Biochim Biophys Acta 2013;1830:5473-9.
- 17. Ranzani OT, Zampieri FG, Forte DN, Azevedo LC, Park M. C-reactive protein/albumin ratio predicts 90-day mortality of septic patients. PLoS One. 2013;8(3):e59321.
- 18. Seringec Akkececi N, Yildirim Cetin G, Gogebakan H, Acipayam C. The C-Reactive Protein/Albumin Ratio and Complete Blood Count Parameters as Indicators of Disease Activity in Patients with Takayasu Arteritis. Med Sci Monit 2019;25:1401-9.
- 19. Pamuk GE, Nuri Pamuk O, Orum H, et al. Elevated plateletmonocyte complexes in patients with psoriatic arthritis. Platelets 2009;20:493-7.
- 20. Unal M, Küçük A, Ünal GÜ, et al. Psoriasiste ortalama trombosit hacmi, nötrofil/lenfosit oranı ve trombosit/lenfosit oranı. Turkderm 2015;49:112-6.
- 21. Duran TI, Pamukcu M. Relationship between disease impact scores and C-reactive protein/albumin ratio in patients with psoriatic arthritis. Croat Med J. 2022;63(2):141-147.
Öz
Giriş ve Amaç: C-reaktif protein (CRP)-albümin (ALB) oranı (CAO), yeni bir inflamatuar biyobelirteç olarak ortaya çıkmıştır. Çalışmanın amacı, psoriatik artrit (PsA) hastalarında CAO'nın klinik önemini değerlendirmektir.
Gereç ve Yöntem: 76 PsA hastası ve 48 sağlıklı kontrol grubu çalışmaya dahil edildi. Hastalar ve kontrollerden onam alındıktan sonra dosya kayıtları incelenerek, demografik bilgiler, başvuru anındaki klinik ve laboratuvar bulguları, nötrofil/lenfosit oranı (NLO), monosit/lenfosit oranı (MLO), trombosit/lenfosit oranı (PLO) ve C-reaktif protein/albümin (CAO) kaydedildi. PsA spesifik bir cilt tutulum ölçütü olan PASI skoru ve şiş-hassas eklem sayıları PsA'daki hastalık aktivitesinin ölçütleri olarak kullanıldı. CAO ile hastalık aktivite belirteçleri (Şiş-hassas eklem sayısı, PASI) ve geleneksel akut faz reaktanları [Eritrosit sedimantasyon hızı (ESH), C-reaktif protein (CRP)] arasındaki korelasyona bakıldı.
Bulgular: PsA hastalarında CAO, sağlıklı gruptan önemli ölçüde yüksekti (p<0,001). Hasta grubunda PLO, CAO, MLO, ESH ve CRP değerleri kontrol grubuna göre istatiksel olarak anlamlı olarak yüksekti (sırasıyla p<0,001, ESH hariç, p=0,007). PsA hastalarında CAO ile PLO, MLO, ESR, CRP değerleri ve şiş-hassas eklem sayıları arasında istatistiksel olarak anlamlı bir ilişki vardı. ROC eğrisi analizi, PsA grubu için CAO'ın eğri altında kalan alanının (AUC) 0,701 olduğunu gösterdi. CAO optimal kesme noktası ≥0,76 kabul edildiğinde, duyarlılık düzeyi %64,5, özgüllük düzeyi %64,6 olarak belirlendi.
Sonuç: CAO, PsA'da inflamasyonu değerlendirmek için basit ve hızlı bir değerlendirme yöntemi olarak günlük uygulamada faydalı olabilir.
Anahtar kelimeler: C-reaktif protein, albümin, psoriatik artrit
Anahtar Kelimeler
Kaynakça
- 1. Calabresi E, Monti S, Governato G, et al. One year in review 2018: psoriatic arthritis. Clin Exp Rheumatol. 2019;37(2):167-178.
- 2. Menon B, Gullick NJ, Walter GJ, et al. Interleukin-17+CD8+ T cells are enriched in the joints of patients with psoriatic arthritis and correlate with disease activity and joint damage progression. Arthritis Rheumatol. 2014;66(5):1272-1281.
- 3. M. Dougados, A. Gueguen, J. P. Nakache et al., “Clinical relevance of C-reactive protein in axial involvement of ankylosing spondylitis,” The Journal of Rheumatology, vol. 26, no. 4, pp. 971–974, 1999.
- 4. Zhong Z, Huang Y, Liu Y, et al. Correlation between C-Reactive Protein to Albumin Ratio and Disease Activity in Patients with Axial Spondyloarthritis. Dis Markers. 2021;2021:6642486.
- 5. Kim DS, Shin D, Lee MS, et al. Assessments of neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in Korean patients with psoriasis vulgaris and psoriatic arthritis. J Dermatol. 2016;43(3):305-310.
- 6. Asahina A, Kubo N, Umezawa Y, Honda H, Yanaba K, Nakagawa H. Neutrophil-lymphocyte ratio, platelet-lymphocyte ratio and mean platelet volume in Japanese patients with psoriasis and psoriatic arthritis: Response to therapy with biologics. J Dermatol. 2017;44(10):1112-1121.
- 7. An, I., Ucmak, D., Ozturk, M., Aksoy, M., Yildiz, I., & Ucan, E. (2021). Neutrophil / Iymphocyte ratio, platelet / Iymphocyte ratio, mean platelet volume and C-reactive protein values in psoriatic arthritis patients . Annals of Medical Research, 26(5), 0894–0898.
- 8. Sunar İ, Ataman Ş. Serum C-Reactive Protein/Albumin Ratio in Rheumatoid Arthritis and its Relationship With Disease Activity, Physical Function, and Quality of Life. Arch Rheumatol. 2020;35(2):247-253.
- 9. Afifi N, M Medhat B, Abdel Ghani AM, Mohamed Ali Hassan HGE, Behiry ME. Value of Albumin-Fibrinogen Ratio and CRP-Albumin Ratio as Predictor Marker of Disease Activity in Egyptian RA Patients, Correlated with Musculoskeletal Sonography. Open Access Rheumatol. 2020;12:241-248.
- 10. Hocanlı İ. , Kabak M. CLINICAL IMPORTANCE OF C-REACTIVE PROTEIN TO ALBUMIN RATIO (CAR) IN COVID-19 PNEUMONIA. J Contemp Med. 2022; 12(2): 266-270.
- 11. Taylor W, Gladman D, Helliwell P, et al. Classification criteria for psoriatic arthritis: development of new criteria from a large international study. Arthritis Rheum. 2006;54(8):2665-2673
- 12. Mease PJ. Measures of psoriatic arthritis: Tender and Swollen Joint Assessment, Psoriasis Area and Severity Index (PASI), Nail Psoriasis Severity Index (NAPSI), Modified Nail Psoriasis Severity Index (mNAPSI), Mander/Newcastle Enthesitis Index (MEI), Leeds Enthesitis Index (LEI), Spondyloarthritis Research Consortium of Canada (SPARCC), Maastricht Ankylosing Spondylitis Enthesis Score (MASES), Leeds Dactylitis Index (LDI), Patient Global for Psoriatic Arthritis, Dermatology Life Quality Index (DLQI), Psoriatic Arthritis Quality of Life (PsAQOL), Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F), Psoriatic Arthritis Response Criteria (PsARC), Psoriatic Arthritis Joint Activity Index (PsAJAI), Disease Activity in Psoriatic Arthritis (DAPSA), and Composite Psoriatic Disease Activity Index (CPDAI). Arthritis Care Res (Hoboken). 2011;63 Suppl 11:S64-S85.
- 13. Guo Y, Cai K, Mao S, et al. Preoperative C-reactive protein/albumin ratio is a significant predictor of survival in bladder cancer patients after radical cystectomy: a retrospective study. Cancer Manag Res. 2018;10:4789-4804.
- 14. Qin G, Tu J, Liu L, Luo L, Wu J, Tao L, et al. Serum albumin and c-reactive protein/albumin ratio are useful biomarkers of Crohn’s disease activity. Med Sci Monit 2016;22:4393-4400.
- 15. Moon JS, Ahn SS, Park YB, Lee SK, Lee SW. C-Reactive Protein to Serum Albumin Ratio Is an Independent Predictor of All-Cause Mortality in Patients with ANCA-Associated Vasculitis. Yonsei Med J 2018;59:865-71.
- 16. Bruschi M, Candiano G, Santucci L, Ghiggeri GM. Oxidized albumin. The long way of a protein of uncertain function. Biochim Biophys Acta 2013;1830:5473-9.
- 17. Ranzani OT, Zampieri FG, Forte DN, Azevedo LC, Park M. C-reactive protein/albumin ratio predicts 90-day mortality of septic patients. PLoS One. 2013;8(3):e59321.
- 18. Seringec Akkececi N, Yildirim Cetin G, Gogebakan H, Acipayam C. The C-Reactive Protein/Albumin Ratio and Complete Blood Count Parameters as Indicators of Disease Activity in Patients with Takayasu Arteritis. Med Sci Monit 2019;25:1401-9.
- 19. Pamuk GE, Nuri Pamuk O, Orum H, et al. Elevated plateletmonocyte complexes in patients with psoriatic arthritis. Platelets 2009;20:493-7.
- 20. Unal M, Küçük A, Ünal GÜ, et al. Psoriasiste ortalama trombosit hacmi, nötrofil/lenfosit oranı ve trombosit/lenfosit oranı. Turkderm 2015;49:112-6.
- 21. Duran TI, Pamukcu M. Relationship between disease impact scores and C-reactive protein/albumin ratio in patients with psoriatic arthritis. Croat Med J. 2022;63(2):141-147.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Romatoloji ve Artrit |
| Bölüm | Araştırma Makalesi |
| Yazarlar | |
| Yayımlanma Tarihi | 28 Eylül 2023 |
| Yayımlandığı Sayı | Yıl 2023 Cilt: 10 Sayı: 3 |
