Value of Albumin-Fibrinogen Ratio and CRP-Albumin Ratio as Predictor Marker of Disease Activity in Egyptian RA Patients, Correlated with Musculoskeletal Sonography
Naglaa Afifi,1,2 Basma M Medhat,3 Amani Mohamed Abdel Ghani,4 Hend Galal eldeen Mohamed Ali Hassan,5 Mervat E Behiry2,6 1Internal Medicine and Rheumatology, Faculty of Medicine, Ain Shams University, Cairo, Egypt; 2Internal Medicine, Armed Forces College of Medicine (AFCM), Cairo, Egypt; 3Rheumatolo...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2020-11-01
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| Series: | Open Access Rheumatology: Research and Reviews |
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| Online Access: | https://www.dovepress.com/value-of-albumin-fibrinogen-ratio-and-crp-albumin-ratio-as-predictor-m-peer-reviewed-article-OARRR |
| _version_ | 1818858213065359360 |
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| author | Afifi N M Medhat B Abdel Ghani AM Mohamed Ali Hassan HGE Behiry ME |
| author_facet | Afifi N M Medhat B Abdel Ghani AM Mohamed Ali Hassan HGE Behiry ME |
| author_sort | Afifi N |
| collection | DOAJ |
| description | Naglaa Afifi,1,2 Basma M Medhat,3 Amani Mohamed Abdel Ghani,4 Hend Galal eldeen Mohamed Ali Hassan,5 Mervat E Behiry2,6 1Internal Medicine and Rheumatology, Faculty of Medicine, Ain Shams University, Cairo, Egypt; 2Internal Medicine, Armed Forces College of Medicine (AFCM), Cairo, Egypt; 3Rheumatology and Rehabilitation, Faculty of Medicine, Cairo University, Cairo, Egypt; 4Clinical Pathology, Faculty of Medicine, Ain Shams University, Cairo, Egypt; 5Radiodiagnosis, Faculty of Medicine, Ain Shams University, Cairo, Egypt; 6Internal Medicine, and Rheumatology, Faculty of Medicine, Cairo University, Cairo, EgyptCorrespondence: Naglaa Afifi Giza 12511, EgyptTel +201100097599Fax +20 26 28 884Email dr.naglaaafifi@gmail.comPurpose: To evaluate the albumin-fibrinogen ratio (AFR) and C-reactive protein-albumin ratio (CAR) as inflammatory markers in rheumatoid arthritis (RA) and to investigate their association with disease activity correlating with musculoskeletal ultrasonographic findings.Patients and Methods: A total of 125 cases of RA patients were consecutively enrolled in a multicenter cross-sectional study compared to 100 healthy controls, all subjects were investigated for fibrinogen, albumin, CRP, erythrocyte sedimentation rate, AFR, and CAR measurements. Patients’ disease activity was assessed by disease activity score (DAS28-ESR), and they were subjected to high-frequency ultrasound both in greyscale and power Doppler.Results: RA patients had lower AFR and higher CAR than those in the control group (P < 0.001). A positive correlation was demonstrated between CAR and DAS score (r=0.589, P = 0.0001), whilst there was a precise negative correlation between AFR and DAS 28-ESR (r=− 0.74, p< 0.001). ROC curve analyses revealed fibrinogen showed the best sensitivity (92.1%) for the area under the curve of 0.928, at a criterion of 2.47, while AFR has an area under the curve of 0.826 with sensitivity and specificity (86.84% and 75%, respectively) at cut-off value 1.46. Actively diseased patients had elevated CAR than those in remission (P < 0.001). Patients with synovial thickening and bone erosions had lower AFR than those without, CAR was higher in patients with power doppler changes than those without (p=0.015).Conclusion: Higher CAR and lower AFR were expressed in active RA than those in remission. CAR and AFR could be useful markers of ongoing inflammation and joint affection detected by musculoskeletal ultrasonography.Keywords: rheumatoid arthritis, albumin-fibrinogen ratio, C-reactive protein, inflammation, ultrasonography |
| first_indexed | 2024-12-19T08:52:42Z |
| format | Article |
| id | doaj.art-046124389a784d8faf5b82e8083c6800 |
| institution | Directory Open Access Journal |
| issn | 1179-156X |
| language | English |
| last_indexed | 2024-12-19T08:52:42Z |
| publishDate | 2020-11-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Open Access Rheumatology: Research and Reviews |
| spelling | doaj.art-046124389a784d8faf5b82e8083c68002022-12-21T20:28:40ZengDove Medical PressOpen Access Rheumatology: Research and Reviews1179-156X2020-11-01Volume 1224124858853Value of Albumin-Fibrinogen Ratio and CRP-Albumin Ratio as Predictor Marker of Disease Activity in Egyptian RA Patients, Correlated with Musculoskeletal SonographyAfifi NM Medhat BAbdel Ghani AMMohamed Ali Hassan HGEBehiry MENaglaa Afifi,1,2 Basma M Medhat,3 Amani Mohamed Abdel Ghani,4 Hend Galal eldeen Mohamed Ali Hassan,5 Mervat E Behiry2,6 1Internal Medicine and Rheumatology, Faculty of Medicine, Ain Shams University, Cairo, Egypt; 2Internal Medicine, Armed Forces College of Medicine (AFCM), Cairo, Egypt; 3Rheumatology and Rehabilitation, Faculty of Medicine, Cairo University, Cairo, Egypt; 4Clinical Pathology, Faculty of Medicine, Ain Shams University, Cairo, Egypt; 5Radiodiagnosis, Faculty of Medicine, Ain Shams University, Cairo, Egypt; 6Internal Medicine, and Rheumatology, Faculty of Medicine, Cairo University, Cairo, EgyptCorrespondence: Naglaa Afifi Giza 12511, EgyptTel +201100097599Fax +20 26 28 884Email dr.naglaaafifi@gmail.comPurpose: To evaluate the albumin-fibrinogen ratio (AFR) and C-reactive protein-albumin ratio (CAR) as inflammatory markers in rheumatoid arthritis (RA) and to investigate their association with disease activity correlating with musculoskeletal ultrasonographic findings.Patients and Methods: A total of 125 cases of RA patients were consecutively enrolled in a multicenter cross-sectional study compared to 100 healthy controls, all subjects were investigated for fibrinogen, albumin, CRP, erythrocyte sedimentation rate, AFR, and CAR measurements. Patients’ disease activity was assessed by disease activity score (DAS28-ESR), and they were subjected to high-frequency ultrasound both in greyscale and power Doppler.Results: RA patients had lower AFR and higher CAR than those in the control group (P < 0.001). A positive correlation was demonstrated between CAR and DAS score (r=0.589, P = 0.0001), whilst there was a precise negative correlation between AFR and DAS 28-ESR (r=− 0.74, p< 0.001). ROC curve analyses revealed fibrinogen showed the best sensitivity (92.1%) for the area under the curve of 0.928, at a criterion of 2.47, while AFR has an area under the curve of 0.826 with sensitivity and specificity (86.84% and 75%, respectively) at cut-off value 1.46. Actively diseased patients had elevated CAR than those in remission (P < 0.001). Patients with synovial thickening and bone erosions had lower AFR than those without, CAR was higher in patients with power doppler changes than those without (p=0.015).Conclusion: Higher CAR and lower AFR were expressed in active RA than those in remission. CAR and AFR could be useful markers of ongoing inflammation and joint affection detected by musculoskeletal ultrasonography.Keywords: rheumatoid arthritis, albumin-fibrinogen ratio, C-reactive protein, inflammation, ultrasonographyhttps://www.dovepress.com/value-of-albumin-fibrinogen-ratio-and-crp-albumin-ratio-as-predictor-m-peer-reviewed-article-OARRRrheumatoid arthritisalbumin- fibrinogen ratioc-reactive proteininflammationultrasonography |
| spellingShingle | Afifi N M Medhat B Abdel Ghani AM Mohamed Ali Hassan HGE Behiry ME Value of Albumin-Fibrinogen Ratio and CRP-Albumin Ratio as Predictor Marker of Disease Activity in Egyptian RA Patients, Correlated with Musculoskeletal Sonography Open Access Rheumatology: Research and Reviews rheumatoid arthritis albumin- fibrinogen ratio c-reactive protein inflammation ultrasonography |
| title | Value of Albumin-Fibrinogen Ratio and CRP-Albumin Ratio as Predictor Marker of Disease Activity in Egyptian RA Patients, Correlated with Musculoskeletal Sonography |
| title_full | Value of Albumin-Fibrinogen Ratio and CRP-Albumin Ratio as Predictor Marker of Disease Activity in Egyptian RA Patients, Correlated with Musculoskeletal Sonography |
| title_fullStr | Value of Albumin-Fibrinogen Ratio and CRP-Albumin Ratio as Predictor Marker of Disease Activity in Egyptian RA Patients, Correlated with Musculoskeletal Sonography |
| title_full_unstemmed | Value of Albumin-Fibrinogen Ratio and CRP-Albumin Ratio as Predictor Marker of Disease Activity in Egyptian RA Patients, Correlated with Musculoskeletal Sonography |
| title_short | Value of Albumin-Fibrinogen Ratio and CRP-Albumin Ratio as Predictor Marker of Disease Activity in Egyptian RA Patients, Correlated with Musculoskeletal Sonography |
| title_sort | value of albumin fibrinogen ratio and crp albumin ratio as predictor marker of disease activity in egyptian ra patients correlated with musculoskeletal sonography |
| topic | rheumatoid arthritis albumin- fibrinogen ratio c-reactive protein inflammation ultrasonography |
| url | https://www.dovepress.com/value-of-albumin-fibrinogen-ratio-and-crp-albumin-ratio-as-predictor-m-peer-reviewed-article-OARRR |
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