Department of Rheumatology and Immunology, Shanghai Jiao Tong University School of Medicine Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai, 200233, China.
Department of Clinical Laboratory, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, 200030, China.
Clin Rheumatol. 2023 Feb;42(2):407-413. doi: 10.1007/s10067-022-06439-x. Epub 2022 Nov 21.
The objective of this study is to characterize the association between platelet to albumin ratio (PAR) and disease activity in patients with ankylosing spondylitis (AS) and axial psoriatic arthritis (axPsA). Baseline platelet count, albumin, PAR, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), Bath ankylosing spondylitis disease index (BASDAI), Bath ankylosing spondylitis functional index (BASFI), and ankylosing spondylitis disease activity score (ASDAS) were collected from patients with a definitive diagnosis of AS or axPsA. Spearman's correlation analysis, quantile regression, and receiver operating characteristic (ROC) curves were performed. Four hundred forty-six patients with AS and 68 patients with axPsA were included. AS patients had higher CRP, ASDAS-CRP, and ASDAS-ESR than axPsA patients (median: CRP, 6.8 vs. 3.5 mg/L, p = 0.02; ASDAS-CRP, 2.32 vs.1.93, p = 0.001; ASDAS-ESR, 2.57 vs.1.97, p = 0.007; respectively). Platelet count, albumin, PAR, ESR, BASDAI, and BASFI did not significantly differ between the two populations (all p > 0.05). In AS patients, PAR was positively correlated with BASDAI (r = 0.204, p < 0.01), BASFI (r = 0.24, p < 0.01), ASDAS-CRP (r = 0.475, p < 0.01), and ASDAS-ESR (r = 0.483, p < 0.01), while these coefficients were not significant in axPsA patients. The quantile regression further confirmed that, in AS patients, PAR was independently associated with BASDAI, BASFI, ASDAS-CRP, and ASDAS-ESR at their individual quantiles (all p < 0.01). However, in axPsA patients, PAR was not significantly associated with these disease activities. The optimal cut-off value of PAR for AS disease activity was 5.87, with an AUC of 0.745, a sensitivity of 72.4%, and a specificity of 71%. PAR could serve as an alternative indicator for AS disease activity. Key Points • Platelet to albumin ratio is independently associated with ankylosing spondylitis disease activity. • Platelet to albumin ratio could serve as an alternative indicator for ankylosing spondylitis disease activity.
本研究旨在描述血小板与白蛋白比值（PAR）与强直性脊柱炎（AS）和轴性银屑病关节炎（axPsA）患者疾病活动之间的相关性。从确诊为 AS 或 axPsA 的患者中收集基线血小板计数、白蛋白、PAR、C 反应蛋白（CRP）、红细胞沉降率（ESR）、Bath 强直性脊柱炎疾病指数（BASDAI）、Bath 强直性脊柱炎功能指数（BASFI）和强直性脊柱炎疾病活动评分（ASDAS）。进行 Spearman 相关分析、分位数回归和受试者工作特征（ROC）曲线分析。共纳入 446 例 AS 患者和 68 例 axPsA 患者。与 axPsA 患者相比，AS 患者的 CRP、ASDAS-CRP 和 ASDAS-ESR 更高（中位数：CRP，6.8 与 3.5mg/L，p=0.02；ASDAS-CRP，2.32 与 1.93，p=0.001；ASDAS-ESR，2.57 与 1.97，p=0.007；分别）。两组人群的血小板计数、白蛋白、PAR、ESR、BASDAI 和 BASFI 无显著差异（均 p>0.05）。在 AS 患者中，PAR 与 BASDAI（r=0.204，p<0.01）、BASFI（r=0.24，p<0.01）、ASDAS-CRP（r=0.475，p<0.01）和 ASDAS-ESR（r=0.483，p<0.01）呈正相关，而在 axPsA 患者中这些系数无统计学意义。分位数回归进一步证实，在 AS 患者中，PAR 与 BASDAI、BASFI、ASDAS-CRP 和 ASDAS-ESR 呈独立相关，在各自的分位数上均具有统计学意义（均 p<0.01）。然而，在 axPsA 患者中，PAR 与这些疾病活动无显著相关性。PAR 预测 AS 疾病活动的最佳截断值为 5.87，AUC 为 0.745，敏感性为 72.4%，特异性为 71%。PAR 可作为 AS 疾病活动的替代指标。关键要点 • 血小板与白蛋白比值与强直性脊柱炎疾病活动独立相关。 • 血小板与白蛋白比值可作为强直性脊柱炎疾病活动的替代指标。
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