Two new inflammatory markers associated with disease activity score-28 in patients with rheumatoid arthritis: Albumin to fibrinogen ratio and C-reactive protein to albumin ratio

Int Immunopharmacol. 2018 Sep:62:293-298. doi: 10.1016/j.intimp.2018.07.007. Epub 2018 Jul 23.

Abstract

Background: The albumin to fibrinogen ratio (AFR) and C-reactive protein to albumin ratio (CAR) have emerged as useful biomarkers to predict systemic inflammation. The aim here is to investigate the relation between AFR/CAR and Disease Activity Score of 28 joints (DAS 28) in rheumatoid arthritis (RA).

Methods: This retrospective study included 160 patients with RA and 159 healthy controls. We divided the RA patients into two groups according to the DAS 28-ESR score. Group 1 included 40 patients with a score of lower than 2.6 (patients in remission) and Group 2 included 120 patients with a score of 2.6 or higher (patients with active disease). The correlations between AFR, CAR and the disease activity were analyzed.

Results: For RA patients, the AFR was lower than those in the control group (P < 0.001). Patients in group 2 had higher CAR than those in group 1 (P < 0.001). The AFR was lower in group 2 than that in group 1. A positively correlation was observed between DAS 28-ESR score and CAR (r = 0.645, P < 0.001), while the correlation between DAS 28-ESR and AFR (r = -0.836, P < 0.001) was negative. AFR was related with decreased risk of RA disease activity (EXP (B) = 0.33, 95% CI (0.21-0.53), P < 0.001).

Conclusions: AFR and CAR are two novel inflammatory markers for monitoring disease activity in patients with RA.

Keywords: Albumin to fibrinogen ratio; C-reactive protein to albumin ratio; Disease activity; Rheumatoid arthritis.

MeSH terms

  • Arthritis, Rheumatoid / blood*
  • Arthritis, Rheumatoid / immunology*
  • Biomarkers / blood
  • C-Reactive Protein / analysis*
  • Female
  • Fibrinogen / analysis*
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Retrospective Studies
  • Serum Albumin / analysis*
  • Severity of Illness Index*

Substances

  • Biomarkers
  • Serum Albumin
  • Fibrinogen
  • C-Reactive Protein