Intersecting pathways: evaluating inflammatory markers and metabolism in chronic spontaneous urticaria with a multi-marker approach.

Abstract

Chronic spontaneous urticaria (CSU) is an inflammatory skin disease with intricate mechanisms. This study comprehensively assessed markers from diverse metabolic pathways, including novel inflammatory indicators, to evaluate their potential for diagnosing and monitoring CSU. In the study involving 90 CSU patients and 90 healthy controls, the levels of albumin, high-density lipoprotein (HDL), fibrinogen, uric acid, D-dimer, C-reactive protein (CRP), and white blood cells (WBC) values were analyzed. The D-dimer/albumin ratio (DAR), fibrinogen/albumin ratio (FAR), and uric acid/HDL ratio (UHR), considered novel inflammatory markers, were calculated. The Urticaria Activity Score 7 (UAS7) was also calculated. Pearson chi-squared test, Mann-Whitney U test, Spearman correlation coefficient, and univariate logistic regression analysis were employed for data analysis. In the patient group, significant elevations were observed in DAR, FAR, fibrinogen, CRP, D-dimer, and UHR values. Additionally, albumin, HDL, and uric acid values exhibited significant decreases. HDL and albumin provided the most accurate results in the univariate logistic regression analysis. CRP had less accuracy, FAR exhibited greater accuracy than fibrinogen, and DAR demonstrated higher accuracy than D-dimer. There was no statistically significant correlation between the UAS7 and parameters. The considerable correlation of CRP with other parameters, except D-dimer, was also remarkable. Indicators from diverse metabolic pathways, including albumin, HDL, uric acid, fibrinogen, D-dimer, and CRP, can be valuable in assessing CSU. In particular, FAR and DAR are emerging as potential markers to consider in the assessment of CSU.