CRP-Albumin Ratio as A Disease Activity Marker in RA Patients, Its Correlation with Musculoskeletal Sonography

Document Type : Original Article

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Abstract

Background: Inflammatory rheumatoid arthritis (RA) worsens over time. Severe symptoms can be avoided with an early diagnosis. RA increases CRP-albumin ratio (CAR) as acute-phase reactants.
Objective: To validate the CAR inflammatory impact in RA and how it correlates with disease activity indices and musculoskeletal ultrasonography.
Methods: Seventy-five RA patients were involved in this cross-sectional research. 50 normal subjects were included as a control group. All participants were tested for CRP, albumin, and CAR. Disease activity indices “The Disease Activity Score 28 (DAS28) with erythrocyte sedimentation rate (ESR), the Modified Health Assessment Questionnaire (MHAQ), and the Clinical Disease Activity Index (CDAI)², and ultrasound, which was performed in both grayscale and power Doppler modes, were utilized to assess the patient's disease activity.
Results: CAR in the RA group was 2.25 (0 -13) and 0.41 (0 - 0.9) among controls (p < 0.001). ESR, albumin, CRP, DAS-28, CDAI, and HAQ scores were all found to be correlated with CAR. In patients with active RA, CAR levels were considerably greater than in patients in remission (P< 0.001). Cases who had synovial thickening and power Doppler alterations had higher CAR (p < 0.001). At a cut-off of (2.6), sensitivity was 79.1%, specificity was 72.3%, and the area under the curve (AUC) was 0.77, as measured by the receiver operating characteristic (ROC) curve.
Conclusion: CAR is a measure that can be evaluated easily and affordably. CAR predicts disease activity among moderate to severely active RA patients.
 

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The Egyptian Journal of Hospital Medicine
Volume 92, Issue 1
July 2023
Pages 5496-5502

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