Atas Dilek Barutcu, Sahin Gizem Kumru, Şengül Şule, Kaya Bülent, Paydaş Saime, Alibaz-Oner Fatma, Direskeneli Haner, Tuglular Serhan, Asicioglu Ebru
Marmara University, School of Medicine, Department of Internal Medicine, Division of Nephrology, Istanbul, Turkey.
Ankara University, School of Medicine, Department of Internal Medicine, Division of Nephrology, Ankara, Turkey.
Mediterr J Rheumatol. 2023 Mar 31;34(1):71-77. doi: 10.31138/mjr.34.1.71. eCollection 2023 Mar.
OBJECTIVE/AIM: C-reactive protein to albumin ratio (CAR) has recently been recognized as an independent prognostic marker for vasculitides. This study aims to investigate CAR and its relationship with disease activity and damage in prevalent ANCA associated vasculitis (AAV) patients.
Fifty-one patients with AAV and 42 age-sex-matched healthy controls were enrolled in this cross-sectional study. Birmingham vasculitis score (BVAS) was used to assess vasculitis activity and vasculitis damage index (VDI) to provide information on disease damage.
The median (25-75) age of the patients were 55 (48-61) years. CAR was significantly higher in AAV patients than controls (1.9±2.7 vs 0.7±0.4; p=0.006). The 75 percentile of BVAS was defined as high BVAS (BVAS≥5) and ROC curve analysis showed that CAR≥0.98 predicted BVAS≥5 with 70.0% sensitivity and 68.0% specificity (AUC:0.660, CI: 0.482-0.837, p=0.049). When patients with CAR≥0.98 were compared to those without, BVAS [5.0 (3.5-8.0) vs. 2.0 (0-3.25), p<0.001], BVAS≥5 [16 (64.0%) vs 4 (15.4%) patients, p:0.001], VDI [4.0 (2.0-4.0) vs. 2.0 (1.0-3.0), p=0.006], and CAR [1.32 (1.07-3.78) vs. 0.75 (0.60-0.83), p<0.001] were higher whereas albumin [3.8 (3.1-4.3) vs. 4.1 (3.9-4.4) g/dL, p=0.025] and haemoglobin [12.1 (10.4-13.4) vs. 13.0 (12.5-14.2) g/dL, p=0.008] were lower. Multivariate analysis revealed that BVAS [OR(95% CI):1.313 (1.003-1.719), p=0.047] was an independent factor associated with CAR≥0.98 in patients with AAV. Furthermore, correlation analysis showed that CAR significantly correlated with BVAS (r: 0.466, p=0.001).
In this study, we observed that CAR was significantly associated with disease activity in AAV patients and can be used to monitor disease activity.
C反应蛋白与白蛋白比值（CAR）最近被认为是血管炎的独立预后标志物。本研究旨在调查CAR及其与常见抗中性粒细胞胞浆抗体相关性血管炎（AAV）患者疾病活动度和损伤的关系。
本横断面研究纳入了51例AAV患者和42例年龄、性别匹配的健康对照。采用伯明翰血管炎评分（BVAS）评估血管炎活动度，血管炎损伤指数（VDI）提供疾病损伤信息。
患者的中位（25-75）年龄为55（48-61）岁。AAV患者的CAR显著高于对照组（1.9±2.7对0.7±0.4；p=0.006）。将BVAS的第75百分位数定义为高BVAS（BVAS≥5），ROC曲线分析显示，CAR≥0.98预测BVAS≥5的敏感性为70.0%，特异性为68.0%（AUC：0.660，CI：0.482-0.837，p=0.049）。当比较CAR≥0.98的患者与未达到该值的患者时，BVAS[5.0（3.5-8.0）对2.0（0-3.25），p<0.001]、BVAS≥5[16例（64.0%）对4例（15.4%）患者，p：0.001]、VDI[4.0（2.0-4.0）对2.0（1.0-3.0），p=0.006]和CAR[1.32（1.07-3.78）对0.75（0.60-0.83），p<0.001]较高，而白蛋白[3.8（3.1-4.3）对4.1（3.9-4.4）g/dL，p=0.025]和血红蛋白[12.1（10.4-13.）对13.0（12.5-14.2）g/dL，p=0.008]较低。多变量分析显示，BVAS[OR（95%CI）：1.313（1.003-1.719），p=0.047]是AAV患者中与CAR≥0.98相关的独立因素。此外，相关性分析显示，CAR与BVAS显著相关（r：0.466，p=0.001）。
在本研究中，我们观察到CAR与AAV患者的疾病活动度显著相关，可用于监测疾病活动度。
