Spondiloartropatili hastalarda C reaktif protein albümin oranı, albümin globülin oranı, platelet lenfosit oranı
Author :
Abstract
Amaç
C-reaktif protein (CRP) albümin oranı (CAO), inflamasyonu değerlendirmek için yeni bir inflamatuar belirteç olarak belirtilmiştir. Serum globülini inflamasyonda artar. Bu çalışmada aksiyal spondiloartritli (AxSpA) hastalarda hastalık aktivitesini ile (CAO), albümin globülin oranı (AGO) ve platelet lenfosit oranı (PLO) arasındaki ilişkiyi incelemektir.
Yöntem
Yetmiş beş aksiyel SpA'lı hasta ve yetmiş beş sağlıklı kontrol retrospektif olarak değerlendirildi. Hasta ve kontrollerin CRP, albümin, globülin, lökosit, lenfosit, nötrofil ve platelet değerleri kaydedildi. CAO, AGO ve PLO hesaplandı. Hastalık aktivitesi BASDAI ve ASDAS ile değerlendirildi.
Bulgular
Ortalama yaş AxSpA hastalarında 38.2±10.39 ve kontrollerde 35.45±8.96 idi. CAO AxSpA hastalarında 0.153±0.2 ve kontrollerde 0.03±0.02 idi (p<0.05). Düşük hastalık aktivitesi olan hastalarda CAO 0.0972±0.16, yüksek hastalık aktivitesi olan hastalarda 0.213±0.275 idi. Yüksek hastalık aktivitesi olan hastalar, düşük hastalık aktivitesi olan hastalardan daha yüksek CAO’ya sahipti (p<0.05). Sırasıyla CAO ile ve BASDAI ve ASDAS arasında istatistiksel olarak anlamlı pozitif korelasyon vardı (rho 327, p<0.05 ve rho 0.523, p<0.05). AxSpA hastalarında AGO daha düşüktü (p<0.05). AGO ile BASDAI arasında negatif korelasyon vardı ancak anlamlı değildi (rho – 0.044, p>0.05). PLO ile BASDAI ve ASDAS arasında anlamlı bir ilişki vardı (rho 236, p<0.05, rho 314, p<0.05 sırasıyla).
Sonuç
CAO ve PLO, AxSpA'lı hastalarda hastalık aktivitesini değerlendirmek için önemli bir belirteçtir. AGO, AxSpA'daki hastalık aktivitesini değerlendirmek için umut verici bir belirteç olabilir.
Keywords
Abstract
Aim The C-reactive protein (CRP) to albumin (CAR) ratio has been reported as a novel inflammatory marker to assess inflammation. Serum globulin increases in inflammation. In this study, it was aimed to evaluate relation between CAR, albumin to globülin ratio (AGR), platelet to lymphocyte ratio (PLR) and disease activity in patients with axial spondyloarthritis (AxSpA).
Method Seventy-five patients with axial SpA and seventy-five healthy controls were evaluated retrospectively. CRP, albumin, globulin, leukocyte, lymphocyte, and platelet from the patients and controls were recorded. CAR, AGR and PLR were calculated. Disease activity was evaluated by the BASDAI and ASDAS.
Results The mean age was 38.2±10.39 in patients with AxSpA and 35.45±8.96 in controls. The CAR was 0.153±0.2 in AxSpA patients and 0.03±0.02 in controls (p<0.05). The CAR was 0.0972±0.16 in patients who had low disease activity and 0.213±0.275 in patients with high disease activity. The patients with high disease activity had higher CAR than patients with low disease activity (p<0.05). There was a statistically significant positive correlation between CAR and BASDAI and ASDAS respectively (rho 327, p<0.05, rho 0.523, p<0.05). The AGR was lower in AxSpA patients (p<0.05). There was a negative correlation between AGR and BASDAI but it was not significant (rho – 0.044, p>0.05). There was significant correlation between PLR and BASDAI and ASDAS (rho 236, p<0.05 and rho 314, p<0.05 respectively).
Conclusion The CAR and PLR are an important markers for evaluating disease activity in patients with AxSpA. AGR may be a promising marker for assessing disease activity in AxSpA.
Keywords
- 1. Bb Deodhar A, Mease PJ, Reveille JD, Curtis JR, Chen S, Malhotra K, Pangan AL.Arthritis Rheumatol. Frequency of Axial Spondyloarthritis Diagnosis Among Patients Seen by US Rheumatologists for Evaluation of Chronic Back Pain. 2016 Jul;68(7):1669-76. doi: 10.1002/art.39612.
- 2. Benhamou M, Gossec L, Dougados M. Clinical relevance of C-reactive protein in ankylosing spondylitis and evaluation of the NSAIDs/coxibs’ treatment effect on C-reactive protein. Rheumatology (Oxford). 2010 Mar;49(3):536-41. doi: 10.1093/rheumatology/kep393.
- 3. J Sieper, J Braun, M Rudwaleit, A Boonen, A Zink. Ankylosing spondylitis: an overview. Extended report. Ann Rheum Dis 2002;61(Suppl III):iii8–iii18
- 4. Don BR, Kaysen G. Serum albumin: relationship to inflammation and nutrition Semin Dial. 2004 Nov- Dec;17(6):432-7. doi: 10.1111/j.0894-0959.2004.17603.x.
- 5. Zhong Z, Huang Y, Liu Y, Chen J, Liu M, Huang Q, Zheng S, Guo X, Deng W, Li T. Correlation between C-Reactive Protein to Albumin Ratio and Disease Activity in Patients with Axial Spondyloarthritis. Dis Markers. 2021 Jun 12;2021:6642486. doi: 10.1155/2021/6642486. eCollection 2021.
- 6. M. Ishizuka, H. Nagata, K. Takagi, Y. Iwasaki, N. Shibuya, and K. Kubota, “Clinical significance of the C-reactive protein to albumin ratio for survival after surgery for colorectal cancer,” Annals of Surgical Oncology, vol. 23, no. 3, pp. 900–907, 2016.
- Res. 2020 Oct 7;15(1):459. doi: 10.1186/s13018-020-01959-1.
- 8. Cai Y, Zhao Y, Dai Q, Xu M, Xu X, Xia W. Prognostic value of the albumin-globulin ratio and albumin- globulin score in patients with multiple myeloma. J Int Med Res. 2021 Mar;49(3):300060521997736. doi: 10.1177/0300060521997736.
- 9. Li K, Fu W, Bo Y, Zhu Y. Effect of albumin-globulin score and albumin to globulin ratio on survival in patients with heart failure: a retrospective cohort study in China. BMJ Open. 2018;8(7):e22960.
- 10. Guo HW, Yuan TZ, Chen JX, Zheng Y. Prognostic value of pretreatment albumin/globulin ratio in digestive system cancers: a meta-analysis. PLoS One. 2018;13(1):e189839.
- 11. Garrett S, Jenkinson T, Kennedy LG, Whitelock H, Gaisford P, Calin A. A new approach to defining disease status in ankylosing spondylitis: the Bath Ankylosing Spondylitis Disease Activity Index. J Rheumatol 1994;21:2286-91, PMID: 7699630
- 12. Lukas C, Landewé R, Sieper J, Dougados M, Davis J, Braun J et al. Development of an ASAS-endorsed disease activity score (ASDAS) in patients with ankylosing spondylitis. Ann Rheum Dis 2009;68:18-24, DOI: 10.1136/ard.2008.094870
- 13. Yanik B, Gürsel YK, Kutlay S, Ay S, Elhan AH. Adaptation of the Bath Ankylosing Spondylitis Functional Index to the Turkish population, its reliability and validity: functional assessment in AS. Clin Rheumatol 2005;24:417, DOI: 10.1007/s10067-004-0968-6
- 14. He Y, Tang J, Wu B, Yang B, Ou Q, Lin J. Correlation between albumin to fibrinogen ratio, C-reactive protein to albumin ratio and Th17 cells in patients with rheumatoid arthritisClin Chim Acta. 2020 Jan;500:149-154. doi: 10.1016/j.cca.2019.10.009
- 15. Pamukcu M, Duran TI. Could C-Reactive Protein/Albumin Ratio be an Indicator of Activation in Axial Spondyloarthritis?J Coll Physicians Surg Pak. 2021 May;30(5):537-541. doi: 10.29271/jcpsp.2021.05.537. PMID: 34027865
- 16. Zhong Z, Huang Y, Liu Y, Chen J, Liu M, Huang Q, Zheng S, Guo X, Deng W, Li T. Correlation between C-Reactive Protein to Albumin Ratio and Disease Activity in Patients with Axial Spondyloarthritis Dis Markers. 2021 Jun 12;2021:6642486. doi: 10.1155/2021/6642486
- 18. Lv GY, An L, Sun XD, Hu YL, Sun DW. Pretreatment albumin to globulin ratio can serve as a prognostic marker in human cancers: a meta-analysis. Clin Chim Acta. 2018 Jan;476:81-91. doi: 10.1016/j.cca.2017.11.019. Epub 2017 Nov 21
- 19. Sütcüoğlu O, Akdoğan O, Gürler F, Kurt İnci B, Özdemir N, Özet A, Yazıcı O. The role of serum albumin/globulin ratio in combination with prognostic risk indexes of febrile neutropenia. Int J Clin Pract. 2021 Jul;75(7): e14185. doi: 10.1111/ijcp.14185.
- 21. 2021 Jan 16;22(1):86. doi: 10.1186/s12891-021-03973-8.
- 22. Gökmen F, Akbal A, Reşorlu H, Gökmen E, Güven M, Aras AB, Erbağ G, Kömürcü E, Akbal E, Coşar M. Neutrophil-Lymphocyte Ratio Connected to Treatment Options and Inflammation Markers of Ankylosing Spondylitis. J Clin Lab Anal. 2015 Jul;29(4):294-8. doi: 10.1002/jcla.21768.
- 23. Mercan R, Bitik B, Tufan A, Bozbulut UB, Atas N, Ozturk MA, Haznedaroglu S, Goker B. The Association Between Neutrophil/Lymphocyte Ratio and Disease Activity in Rheumatoid Arthritis and Ankylosing Spondylitis J Clin Lab Anal. 2016 Sep;30(5):597-601. doi: 10.1002/jcla.21908.
- 24. Song GG, Lee YH. Red cell distribution width, platelet-to-lymphocyte ratio, and mean platelet volume in ankylosing spondylitis and their correlations with inflammation: A meta-analysis. Mod Rheumatol. 2020 Sep;30(5):894-899. doi: 10.1080/14397595.2019.1645373.
