Is Serum C- Reactive Protein to Albumin Ratio Be A New Biomarker for Assessing Disease Activity and Quality of Life in Rheumatoid Arthritis?

Abstract

The C-reactive protein (CRP)/albumin ratio is a biomarker that has gained importance in recent years in demonstrating systemic inflammation. The aim of this study was to evaluate the relationship of CRP/albumin ratio with disease activity and quality of life in patients with rheumatoid arthritis (RA). Fifty RA patients were included in this cross-sectional study. The CRP/albumin ratio was calculated from the blood of the individuals included in the study. The disease activity score-28 (DAS-28) measurement scale was used to determine disease activity. The Health Assessment Questionnaire (HAQ) was used to assess functional status, and the Short-form health survey 36 (SF-36) was used to assess the quality of life. When the patients were evaluated according to the disease activity level, the CRP/albumin ratio was statistically significantly higher in patients with moderate-high disease activity compared to those in remission in post-hoc analyses (p=0.006). In correlation analyzes, moderate and positive correlation (p=0.002, rs= 0.426; p<0.001, rs= 0.536, respectively) was observed between CRP/albumin ratio and erythrocyte sedimentation rate (ESR) and DAS 28-ESR scores. When the patients were evaluated according to the drug treatments they received, no significant difference was observed between conventional DMARD and biological DMARD users in terms of CRP/albumin ratio, SF-36, and HAQ scores (p>0.05). Our results suggest that CAR may be used in clinics to determine inflammation and disease activity as an inexpensive and easily applicable biomarker.