Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, China.
National Center for Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China.
Front Endocrinol (Lausanne). 2024 May 30;15:1415488. doi: 10.3389/fendo.2024.1415488. eCollection 2024.
Inflammation contributes to the development of metabolic bone diseases. The C-reactive protein-to-albumin ratio (CAR) is an inflammation-based marker with a prognostic value for several metabolic diseases. This study investigated the relationship between the CAR and osteoporosis (OP) in patients with primary biliary cholangitis (PBC).
Patients with PBC treated at Beijing Ditan Hospital between January 2018 and June 2023 were enrolled. Logistic regression analysis was performed to investigate the factors influencing OP. The predictive value of CAR for OP was evaluated using receiver operating characteristic (ROC) curves. Moreover, a restricted cubic spline (RCS) fitted with a logistic regression model was used to analyze the relationship between CAR and OP.
The prevalence of OP among the patients with PBC was 26.9% (n = 82). CAR levels were higher in the OP group than in the non-OP group (0.33 (0.09, 0.61) vs. 0.08 (0.04, 0.18), P < 0.001). Logistic regression analysis showed that CAR was an independent predictor of OP in patients with PBC (odds ratio = 2.642, 95% confidence interval = 1.537-4.540, P < 0.001). CAR exhibited a good predictive ability for OP, with an areas under the curve (AUC) of 0.741. We found that individuals with CAR values > 0.1 have higher odds of OP. In addition, high CAR levels were associated with an increased prevalence of fragility fractures and high 10-year fracture risk.
High CAR levels were associated with greater odds of developing OP, and the CAR could serve as an independent predictor of OP in patients with PBC.
炎症是代谢性骨病发展的一个因素。C 反应蛋白与白蛋白比值（CAR）是一种基于炎症的标志物，对多种代谢性疾病具有预后价值。本研究探讨了原发性胆汁性胆管炎（PBC）患者的 CAR 与骨质疏松症（OP）之间的关系。
纳入 2018 年 1 月至 2023 年 6 月在北京地坛医院接受治疗的 PBC 患者。采用 logistic 回归分析探讨影响 OP 的因素。采用受试者工作特征（ROC）曲线评估 CAR 对 OP 的预测价值。此外，采用 logistic 回归模型拟合受限立方样条（RCS）分析 CAR 与 OP 之间的关系。
PBC 患者中 OP 的患病率为 26.9%（n=82）。OP 组的 CAR 水平高于非 OP 组（0.33（0.09，0.61）vs.0.08（0.04，0.18），P<0.001）。logistic 回归分析显示，CAR 是 PBC 患者发生 OP 的独立预测因子（比值比=2.642，95%置信区间=1.537-4.540，P<0.001）。CAR 对 OP 具有良好的预测能力，曲线下面积（AUC）为 0.741。我们发现，CAR 值>0.1 的个体发生 OP 的可能性更高。此外，高 CAR 水平与脆性骨折发生率增加和 10 年骨折风险增加相关。
高 CAR 水平与发生 OP 的可能性增加相关，CAR 可作为 PBC 患者发生 OP 的独立预测因子。
