Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Jun 22:2020:3467419.
doi: 10.1155/2020/3467419. eCollection 2020.

The Relationship between C-Reactive Protein/Albumin Ratio and Disease Activity in Patients with Inflammatory Bowel Disease

Affiliations

The Relationship between C-Reactive Protein/Albumin Ratio and Disease Activity in Patients with Inflammatory Bowel Disease

Yi-Han Chen et al. Gastroenterol Res Pract. .

Abstract

Objectives: The aims of this study were to evaluate the C-reactive protein/albumin ratio (CRP/ALB), inflammatory markers, and parameters from the complete blood count (CBC) in patients with inflammatory bowel disease (IBD) and their associations with disease activity.

Methods: A total of 876 IBD patients, composed of 275 patients with ulcerative colitis (UC) and 601 patients with Crohn's disease (CD), were included in this retrospective study, and the serum C-reactive protein (CRP), albumin (ALB), erythrocyte sedimentation rate (ESR), and CBC parameters were measured. To explore the disease activity, the Mayo score and Crohn disease activity index were used to assess UC and CD patients, respectively.

Results: The CRP/ALB ratio, CRP, ESR, platelet to lymphocyte ratio (PLR), red blood cell distribution width (RDW), and neutrophil to lymphocyte ratio (NLR) levels in active IBD patients were significantly higher than those in inactive IBD patients, whereas ALB and lymphocyte to monocyte ratio (LMR) levels were significantly decreased (P < 0.001). The receiver operating characteristic analysis showed that the optimum cut-off values of the CRP/ALB ratio for active UC and CD were 0.18 and 0.43, with sensitivities of 67.8% and 75.8% and specificities of 86.7% and 92.0%, respectively. Multivariable logistic analysis revealed that after adjusting for these inflammatory markers (ESR, NLR, PLR, and LMR), the CRP/ALB ratio was a statistically significant parameter capable of differentiating the disease activity of UC and CD.

Conclusions: This study indicated that the CRP/ALB ratio was closely related to the IBD disease activity. Compared with CBC parameters, the CRP/ALB ratio had a higher discriminative capacity for active IBD.

PubMed Disclaimer

Conflict of interest statement

All authors declare that they have no competing interests.

Figures

Figure 1
Figure 1
Receiver operating characteristic (ROC) curve of CRP/ALB vs. other inflammatory markers in predicting active UC.
Figure 2
Figure 2
Receiver operating characteristic (ROC) curve of CRP/ALB vs. other inflammatory markers in predicting active CD.

References

    1. Molodecky N. A., Soon I. S., Rabi D. M., et al. Increasing incidence and prevalence of the inflammatory bowel diseases with time, based on systematic review. Gastroenterology. 2012;142(1):46–54.e42. doi: 10.1053/j.gastro.2011.10.001. quiz e30. - DOI - PubMed
    1. Magro F., Gionchetti P., Eliakim R., et al. Third European evidence-based consensus on diagnosis and management of ulcerative colitis. Part 1: definitions, diagnosis, extra-intestinal manifestations, pregnancy, cancer surveillance, surgery, and ileo-anal pouch disorders. Journal of Crohn's & Colitis. 2017;11(6):649–670. doi: 10.1093/ecco-jcc/jjx008. - DOI - PubMed
    1. Gomollón F., Dignass A., Annese V., et al. 3rd European evidence-based consensus on the diagnosis and management of Crohn’s disease 2016: part 1: diagnosis and medical management. Journal of Crohn's & Colitis. 2016;11(1):3–25. doi: 10.1093/ecco-jcc/jjw168. - DOI - PubMed
    1. Faubion W. A., Jr., Fletcher J. G., OʼByrne S., et al. EMerging BiomARKers in Inflammatory Bowel Disease (EMBARK) study identifies fecal calprotectin, serum MMP9, and serum IL-22 as a novel combination of biomarkers for Crohn's disease activity: role of cross-sectional imaging. The American Journal of Gastroenterology. 2013;108(12):1891–1900. doi: 10.1038/ajg.2013.354. - DOI - PubMed
    1. Cherfane C. E., Gessel L., Cirillo D., Zimmerman M. B., Polyak S. Monocytosis and a low lymphocyte to monocyte ratio are effective biomarkers of ulcerative colitis disease activity. Inflammatory Bowel Diseases. 2015;21(8):1769–1775. doi: 10.1097/MIB.0000000000000427. - DOI - PMC - PubMed