Sayar Suleyman, Kurbuz Kemal, Kahraman Resul, Caliskan Zuhal, Atalay Roni, Ozturk Oguzhan, Doganay Hamdi Levent, Ozdil Kamil
Department of Gastroenterology, Saglık Bilimleri University Umraniye Training and Research Hospital, Istanbul, Turkey.
North Clin Istanb. 2019 Nov 25;7(1):49-55. doi: 10.14744/nci.2018.78800. eCollection 2020.
There are many instruments to measure disease activity in ulcerative colitis. While determining clinical activity according to these instruments, many clinical and laboratory parameters are needed to be followed. Determination of disease activity with non-invasive and objective inflammatory indicators may be a practical and objective way. CRP/Albumin ratio (CAR) is an inflammatory marker that is considered to have prognostic value in various cancers, sepsis and acute pancreatitis. In this study, we aim to investigate diagnostic performance CAR in determining the clinical severity of ulcerative colitis.
Between November 2011 and February 2017, hospital records and follow-up cards of patients with ulcerative colitis were reviewed retrospectively. One hundred forty-nine patients were included in this study. Patient's demographic data, laboratory values, clinical disease activity, according to Truelove & Witts criteria and endoscopic activity according to the Mayo sub-score and treatments, were recorded. Diagnostic performance of CAR analyzed to determine the clinical severity.
Of the patients included in this study, 99 (62%) were male, and 50 (38%) were female. Mean age was 45.22±14 years. When patients were grouped into remission, mild, moderate and severe disease according to disease activity, there was a statistically significant difference between CRP, CAR, erythrocyte sedimentation rate (ESR) and albumin levels (p=0.001; p<0.05). Area under the curve (AUC) values for the diagnosis of severe disease were 0.941, 0.931, 0.888 and 0.883 for CAR, CRP, ESR and albumin levels, respectively. Cut-off value to determine severe disease for CAR was 0.6 (sensitivity: 88.9%, specificity of 90.3%, positive predictive value (PPV) 85.1%, negative predictive value (NPV) 92.8%, AUC: 0.941, p<0.001).
There was a significant relationship between CAR, CRP, ESR and albumin levels and clinical disease severity in patients with ulcerative colitis. CAR is a cheap and practical marker for the diagnosis of acute severe ulcerative colitis.
有多种工具可用于测量溃疡性结肠炎的疾病活动度。在根据这些工具确定临床活动度时，需要跟踪许多临床和实验室参数。使用非侵入性且客观的炎症指标来确定疾病活动度可能是一种实用且客观的方法。CRP/白蛋白比值（CAR）是一种炎症标志物，被认为在各种癌症、脓毒症和急性胰腺炎中具有预后价值。在本研究中，我们旨在调查CAR在确定溃疡性结肠炎临床严重程度方面的诊断性能。
回顾性分析2011年11月至2017年2月期间溃疡性结肠炎患者的医院记录和随访卡。本研究纳入了149例患者。记录患者的人口统计学数据、实验室值、根据Truelove&Witts标准的临床疾病活动度、根据Mayo子评分的内镜活动度以及治疗情况。分析CAR的诊断性能以确定临床严重程度。
本研究纳入的患者中，99例（62%）为男性，50例（38%）为女性。平均年龄为45.22±14岁。当根据疾病活动度将患者分为缓解期、轻度、中度和重度疾病时，CRP、CAR、红细胞沉降率（ESR）和白蛋白水平之间存在统计学显著差异（p = 0.001；p < 0.05）。CAR、CRP、ESR和白蛋白水平诊断重度疾病的曲线下面积（AUC）值分别为0.941、0.931、0.888和0.883。确定CAR重度疾病的临界值为0.6（敏感性：88.9%，特异性90.3%，阳性预测值（PPV）85.1%，阴性预测值（NPV）92.8%，AUC：0.941，p < 0.001）。
溃疡性结肠炎患者中，CAR、CRP、ESR和白蛋白水平与临床疾病严重程度之间存在显著关系。CAR是诊断急性重度溃疡性结肠炎的一种廉价且实用的标志物。
