Relationship between disease impact scores and C-reactive protein/albumin ratio in patients with psoriatic arthritis

Abstract

Aim: To evaluate the relationships between the C-reactive protein (CRP)/albumin ratio (CAR), neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and Disease Activity in Psoriatic Arthritis (DAPSA) and Psoriatic Arthritis Impact of Disease 12-item-questionnaire (PsAID-12) scores in patients with psoriatic arthritis (PsA).

Methods: This cross-sectional study involved 160 (121 female) patients with PsA who were >18 years old and treated in the rheumatology clinic of Dışkapı Yıldırım Beyazıt Education and Research Hospital between January 2020 and January 2021. Demographic and clinical data, PsAID-12 and DAPSA scores, CRP, erythrocyte sedimentation rate (ESR), albumin level, neutrophil, lymphocyte, and platelet counts were recorded.

Results: The mean age was 46.49±11.12 years; median (min-max) disease duration was 2 years (0.5-34). The PsAID score was ≥4 (high disease impact) in 74.4% of patients. Patients with high disease impact had significantly higher CRP, ESR, CAR, NLR, PLR, neutrophil counts, and DAPSA scores (P<0.001). PsAID scores significantly highly correlated with CRP (rho 0.864, P<0.001), DAPSA significantly highly correlated with the CAR (rho 0.890, P<0.001). Receiver operating characteristic curve analysis showed that the CAR (area under the curve [AUC] 0.901, P<0.05, 95% confidence interval [CI] 0.855-0.947, NLR (AUC 0.759, P<0.05, 95% CI 0.680-0.838), and PLR (AUC 0.686, P<0.05, 95% CI 0.591-0.782) predicted high disease impact. The cut-off value for the CAR was 0.98.

Conclusion: The CAR can be useful in daily practice as a simple and quick assessment method to evaluate disease impact in PsA.

Figure 1

The power of the C reactive protein/albumin ratio (CAR), neutrophil/lymphocyte ratio (NLR), and platelet/lymphocyte ratio (PLR) values to predict high Psoriatic Arthritis Impact of Disease score. Diagonal segments are produced by ties.