Ekin Ali, Mısırcı Salim, Öztop Hikmet, Hacımustafaoğlu Asuman Şebnem, Coşkun Belkıs Nihan, Yağız Burcu, Dalkılıç Ediz, Pehlivan Yavuz
Divison of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Bursa Uludag University, 16059 Bursa, Turkey.
Department of Internal Medicine, Faculty of Medicine, Bursa Uludag University, 16059 Bursa, Turkey.
Diagnostics (Basel). 2024 Dec 11;14(24):2780. doi: 10.3390/diagnostics14242780.
BACKGROUND/OBJECTIVES: The objective of this study was to evaluate the diagnostic accuracy of the lactate dehydrogenase-to-albumin ratio (LAR) in adult-onset Still's disease (AOSD) and compare it with other inflammatory indices, using patients with fever of unknown origin (FUO) as a control group due to their overlapping clinical features with AOSD. The study also compared LAR's diagnostic performance with other inflammatory indices like the serum immune-inflammatory index (SII), ferritin/erythrocyte sedimentation rate (FER), CRP/albumin ratio (CAR), platelet/lymphocyte ratio (PLR), and neutrophil/lymphocyte ratio (NLR), as well as its combinations with FER, PLR, and ferritin (LAR + FER, LAR + PLR, LAR + ferritin).
A retrospective evaluation was conducted on 70 patients with fever of unknown cause and 78 patients with AOSD, admitted between January 2000 and December 2023 in a tertiary care hospital. Demographic, clinical, and laboratory characteristics were compared between the groups. ROC analysis provided cutoff values, sensitivity, and specificity for each inflammatory index.
ROC analysis showed significant -values ( < 0.05) for indices other than LAR ( = 0.090) LAR + PLR ( = 0.806), and PLR ( = 0.634) in diagnosing AOSD. The highest specificity was found in LAR + ferritin (92.90%), and the highest sensitivity in CAR (100.0%). NLR, SII, FER, and LAR + FER were the indices with both sensitivity and specificity above 50%. LAR had a sensitivity of 76.90% and a specificity of 48.60%. The cutoff values were 3978.0 µg/L for ferritin and 70.98 for LAR. Significant statistical differences between AOSD and non-AOSD groups were observed for all indices except CAR ( = 0.133).
LAR can differentiate AOSD patients from FUO, but its specificity is lower than most other indices. The diagnostic utility of these indices in clinical practice remains controversial.
背景/目的：本研究的目的是评估乳酸脱氢酶与白蛋白比值（LAR）在成人斯蒂尔病（AOSD）中的诊断准确性，并将其与其他炎症指标进行比较，由于不明原因发热（FUO）患者与AOSD具有重叠的临床特征，因此将其作为对照组。该研究还比较了LAR与其他炎症指标如血清免疫炎症指数（SII）、铁蛋白/红细胞沉降率（FER）、CRP/白蛋白比值（CAR）、血小板/淋巴细胞比值（PLR）和中性粒细胞/淋巴细胞比值（NLR）的诊断性能，以及LAR与FER、PLR和铁蛋白的联合指标（LAR+FER、LAR+PLR、LAR+铁蛋白）。
对2000年1月至2023年12月在一家三级医院收治的70例不明原因发热患者和78例AOSD患者进行回顾性评估。比较两组患者的人口统计学、临床和实验室特征。ROC分析提供了每个炎症指标的临界值、敏感性和特异性。
ROC分析显示，除LAR（P=0.090）、LAR+PLR（P=0.806）和PLR（P=0.634）外，其他指标在诊断AOSD时P值均有统计学意义（P<0.05）。LAR+铁蛋白的特异性最高（92.90%），CAR的敏感性最高（100.0%）。NLR、SII、FER和LAR+FER是敏感性和特异性均高于50%的指标。LAR的敏感性为76.90%，特异性为48.60%。铁蛋白的临界值为3978.0μg/L，LAR的临界值为70.98。除CAR外（P=0.133），所有指标在AOSD组和非AOSD组之间均观察到显著的统计学差异。
LAR可以将AOSD患者与FUO患者区分开来，但其特异性低于大多数其他指标。这些指标在临床实践中的诊断效用仍存在争议。
