Could Complete Blood Count Sub-Parameters to Albumin Ratios be Biomarkers of Disease Activity in Rheumatoid Arthritis?
Mestan Şahin1, Mevlüt Üzümcü1, Meltem Alkan Melikoglu21Department Of Internal Medicine, Rheumatology Division, Ataturk University, School Of Medicine, Erzurum, Turkiye2Department Of Physical Medicine And Rehabilitation, Ataturk University, School Of Medicine, Erzurum, Türkiye
3Department Of Rehabilitation, Rheumatology Division, Ataturk University, School Of Medicine, Erzurum, Turkiye
INTRODUCTION: Our aim was to explore the potential of monocyte to albumin ratio (MAR), neutrophil to albumin ratio (NAR), platelet to albumin ratio (PAR), C-reactive protein to albumin ratio (CAR), neutrophil/lymphocyte ratio (NLR), monocyte/lymphocyte ratio (MLR), platelet/lymphocyte ratio (PLR) and platelet/monocyte ratio (PMR) as biomarkers of disease activity in rheumatoid arthritis (RA).
METHODS: Cases with RA and healthy controls were included in this cross-sectional study. Demographic features, disease duration current medications, RA disease activity scores (DAS28-ESH, DAS28-CRP, Simplified Disease Activity Index; SDAI, Clinical Disease Activity Index; CDAI) were recorded. Complete blood count (CBC), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and serum albumin levels were obtained. MAR, NAR, PAR, CAR, NLR, MLR, PLR, PMR were calculated. These parameters were compared between patient and controls, correlations between these parameters and disease activity and their discriminatory ability were analyzed.
RESULTS: Fifty-four RA patients and 57 controls were included. Significantly higher levels of CAR, MAR, NAR, and MLR were observed in patients than controls (p=0.001, 0.004, <0.001, 0.006, 0.004, 0.001, 0.032, respectively). There was a significant difference between active and inactive patients in terms of ESR, CRP and CAR according to DAS28-ESH (p=0.004, 0.018, 0.014, respectively), while no difference was detected between other parameters. CAR and NAR exhibited notable correlations with clinical disease activity scores.
DISCUSSION AND CONCLUSION: Higher CAR, MAR, NAR, and MLR in patients with RA, and their correlations with disease activity were determined. By demonstrating their discriminatory potential, they could serve as biomarkers to complement clinical assessments in RA.
Manuscript Language: English