Sunar İsmihan, Ataman Şebnem
Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Ankara University School of Medicine, Ankara, Turkey.
Arch Rheumatol. 2020 Feb 7;35(2):247-253. doi: 10.46497/ArchRheumatol.2020.7456. eCollection 2020 Jun.
This study aims to evaluate the relationship between C-reactive protein (CRP)/albumin ratio (CAR) and disease activity, quality of life (QoL), and physical function in rheumatoid arthritis (RA).
A total of 121 RA patients (22 males, 99 females; mean age 57.6±11.2 years; range, 32 to 85 years) applying to Ankara University School of Medicine Rheumatology Outpatient Clinic between January 2019 and February 2019 were included in this cross-sectional study. The inclusion criteria were fulfilling the American College of Rheumatology/European League Against Rheumatism 2010 RA classification criteria, being over 18 years and accepting to participate in the study. Demographic and clinical parameters including serum erythrocyte sedimentation rate (ESR), CRP and albumin levels were recorded. Disease activity was measured using Disease Activity Score 28 (DAS28)-ESR. General health, fatigue, and pain were questioned by means of a 100 mm visual analog scale (VAS). The QoL was assessed with the Rheumatoid Arthritis Quality of Life (RAQoL) Questionnaire. The functional status was determined using the Health Assessment Questionnaire (HAQ).
Rheumatoid factor (RF) was positive in 56.2% of the patients. The median ESR was 19.0 mm/hour [interquartile range (IQR): 19.5] and median CRP was 5.6 (IQR: 9) mg/L. The median CAR was 1.3 (IQR: 2.1) and median DAS 28-ESR was 3.6 (IQR: 1.5). There was a significant but weak correlation between CAR and DAS28-ESR [p<0.001, Spearman's correlation coefficient (rs)=0.327]. Moreover, CAR was positively correlated with ESR, CRP, and VAS physician's global assessment (p<0.001, rs=0.497; p<0.001, rs=0.987, p<0.001, rs=0.401, respectively). However, no correlation was observed between CAR, HAQ, and RAQoL. In the RF positive group, there was a significant but weak correlation between CAR and RF titers (p=0.016, rs=0.292).
We observed a positive but weak correlation between CAR and DAS28-ESR, ESR, and the RF titer. Further studies are warranted to investigate the role of CAR in RA.
本研究旨在评估C反应蛋白（CRP）/白蛋白比值（CAR）与类风湿关节炎（RA）的疾病活动度、生活质量（QoL）及身体功能之间的关系。
本横断面研究纳入了2019年1月至2019年2月期间前往安卡拉大学医学院风湿病门诊就诊的121例RA患者（22例男性，99例女性；平均年龄57.6±11.2岁；范围32至85岁）。纳入标准为符合美国风湿病学会/欧洲抗风湿病联盟2010年RA分类标准、年龄超过18岁且同意参与本研究。记录人口统计学和临床参数，包括血清红细胞沉降率（ESR）、CRP和白蛋白水平。使用疾病活动评分28（DAS28）-ESR来测量疾病活动度。通过100mm视觉模拟量表（VAS）询问一般健康状况、疲劳和疼痛情况。使用类风湿关节炎生活质量（RAQoL）问卷评估生活质量。使用健康评估问卷（HAQ）确定功能状态。
56.2%的患者类风湿因子（RF）呈阳性。ESR中位数为19.0mm/小时[四分位数间距（IQR）：19.5]，CRP中位数为5.6（IQR：9）mg/L。CAR中位数为1.3（IQR：2.1），DAS 28-ESR中位数为3.6（IQR：1.5）。CAR与DAS28-ESR之间存在显著但较弱的相关性[p<0.001，Spearman相关系数（rs）=0.327]。此外，CAR与ESR、CRP及VAS医生整体评估呈正相关（分别为p<0.001，rs=0.497；p<0.001，rs=0.987；p<0.001，rs=0.401）。然而，未观察到CAR与HAQ及RAQoL之间存在相关性。在RF阳性组中，CAR与RF滴度之间存在显著但较弱的相关性（p=0.016，rs=0.292）。
我们观察到CAR与DAS28-ESR、ESR及RF滴度之间呈正相关但较弱。有必要进一步研究以探讨CAR在RA中的作用。
