Uslu Sadettin, Tasgöz Filiz Cemre
Rheumatology, Manisa Celal Bayar University School of Medicine, Manisa, TUR.
Cureus. 2024 Aug 15;16(8):e66929. doi: 10.7759/cureus.66929. eCollection 2024 Aug.
Nowadays, one measure that is more helpful in assessing the level of inflammation than either C-reactive protein (CRP) or albumin alone is the C-reactive protein-to-albumin ratio (CAR). Our study set out to assess the CAR in elderly individuals with rheumatoid arthritis (RA) and its correlation with other parameters.
Included in the research were patients who were being followed up on for RA between January 2021 and January 2024 and categorized according to their age at the time of enrolment and assigned to one of two groups: younger patients, defined as <60 years of age, and those aged ≥60 years, who were recorded as elderly patients. The clinical evaluation of the patients and laboratory data measured for each patient included age, gender, disease duration, medications, CRP, erythrocyte sedimentation rate (ESR), albumin, neutrophil-to-lymphocyte ratio (NLR), and CAR. Disease activity was assessed with the disease activity score 28 (DAS 28)-ESR. The health assessment questionnaire was used to measure the functional status.
Ninety-four patients (<60 years: 58 and ≥60 years: 36) were included. The mean age of the elderly patients was 65.80 ± 5.33 years. Female predominance was similar in both the RA groups (<60 years: 50 patients (86.2%) vs. ≥60 years: 31 (86.1%)). The distribution of biological and disease-modifying drugs did not significantly differ between the groups. With the exception of albumin, there was no statistically significant difference between the groups for ESR, CRP, CAR, NLR, or DAS28-ESR. Elderly patients with a DAS28-ESR of 2.6 and above had a statistically significant higher CAR than the remission group (3.44±3.73 vs. 2.71±5.73, respectively). There was no statistically significant difference in the NLR value of elderly patients with a DAS28-ESR of 2.6 and above compared to the remission group (3.06 ± 2.95 vs. 2.65 ± 1.38, respectively). In addition, CAR was positively correlated with ESR, CRP, and DAS28-ESR (r = 0.726, p < 0.001; r = 0.954, p < 0.001; r = 0.339, p = 0.043, respectively). However, there was no discernible correlation between CAR and HAQ, NLR, or disease duration.
In elderly RA patients, our study demonstrated the correlation between CAR and inflammatory biomarkers and the DAS28-ESR. According to this, CAR may prove to be a useful biomarker for assessing inflammation and disease activity in clinical settings.
如今，在评估炎症水平方面，一种比单独使用C反应蛋白（CRP）或白蛋白更有帮助的指标是C反应蛋白与白蛋白比值（CAR）。我们的研究旨在评估类风湿关节炎（RA）老年患者的CAR及其与其他参数的相关性。
研究纳入了2021年1月至2024年1月期间接受RA随访的患者，并根据入组时的年龄进行分类，分为两组：年龄小于60岁的年轻患者和年龄大于或等于60岁的老年患者。对患者的临床评估和为每位患者测量的实验室数据包括年龄、性别、病程、用药情况、CRP、红细胞沉降率（ESR）、白蛋白、中性粒细胞与淋巴细胞比值（NLR）和CAR。采用疾病活动评分28（DAS 28）-ESR评估疾病活动度。使用健康评估问卷测量功能状态。
共纳入94例患者（年龄小于60岁：58例；年龄大于或等于60岁：36例）。老年患者的平均年龄为65.80±5.33岁。两个RA组中女性占主导的情况相似（年龄小于60岁组：50例患者（86.2%） vs. 年龄大于或等于60岁组：31例（86.1%））。两组间生物制剂和改善病情药物的使用分布无显著差异。除白蛋白外，两组在ESR、CRP、CAR、NLR或DAS28-ESR方面无统计学显著差异。DAS28-ESR为2.6及以上的老年患者的CAR显著高于缓解组（分别为3.44±3.73 vs. 2.71±5.73）。DAS28-ESR为2.6及以上的老年患者的NLR值与缓解组相比无统计学显著差异（分别为3.06±2.95 vs. 2.65±1.38）。此外，CAR与ESR、CRP和DAS28-ESR呈正相关（r分别为0.726，p<0.001；r为0.954，p<0.001；r为0.339，p=0.043）。然而，CAR与HAQ、NLR或病程之间无明显相关性。
在老年RA患者中，我们的研究证明了CAR与炎症生物标志物及DAS28-ESR之间的相关性。据此，CAR可能被证明是临床环境中评估炎症和疾病活动度的有用生物标志物。
