POS1443 RELATIONSHIP BETWEEN FIBRINOGEN TO ALBUMIN RATIO AND DISEASE ACTIVITY IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS

Abstract

Background:Systemic lupus erythematosus (SLE) is a systemic inflammatory autoimmune disease characterized by excessive production of immune complexes and proinflammatory cytokine. Low complement, neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) have been used as inflammatory biomarkers to assess the disease activity of SLE. Recently, the fibrinogen to albumin ratio (FAR) has emerged as an effective indicator to reflect the systemic inflammation in many diseases. However, the role of FAR in SLE has been scarcely studied.Objectives:This study was to investigate the association between FAR and SLE Disease Activity Index 2000 (SLEDAI-2K) in SLE.Methods:This retrospective study included 74 SLE patients and 79 age- and sex-matched healthy subjects. According to the SLEDAI-2K score, SLE patients were divided into Group 1 with a score ≤ 9 (patients with mild disease activity, N = 41) and Group 2 with a score > 9 (patients with moderate to severe disease activity, N = 33). Neutrophil, lymphocyte, monocyte, platelet, albumin, fibrinogen, NLR, PLR, monocyte to lymphocyte ratio (MLR), FAR, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), complement 3 (C3), complement 4 (C4) and SLEDAI-2K were collected. Receiver operation characteristic (ROC) curves were conducted to discriminate SLE patients from healthy controls and SLE patients with different disease activity. Correlations between the inflammatory markers and SLEDAI-2K were analyzed.Results:FAR, NLR, PLR, MLR and fibrinogen in SLE patients were higher compared to those of the healthy controls (P < 0.05), while albumin was lower (P < 0.05). Patients in Group 2 had higher levels of FAR, NLR, PLR, fibrinogen and CRP than those in Group 1 (P < 0.05) except MLR (P = 0.579) and ESR (P = 0.130), albumin and C3 were lower (P < 0.05). Furthermore, FAR were higher in SLE patients with nephritis than those without nephritis (P = 0.009). The ROC curve for differentiating SLE patients from healthy individuals showed that the area under curve (AUC) of FAR (0.801, 95%CI: 0.728 - 0.874) and albumin (0.833, 95%CI: 0.764-0.903) were higher than NLR (0.798, 95%CI: 0.725 - 0.871), PLR (0.680, 95%CI: 0.588 - 0.771), MLR (0.785, 95%CI: 0.712 - 0.859) and fibrinogen (0.645, 95%CI: 0.556 - 0.733). Besides, the ROC curve for predicting the disease activity of SLE patients indicated that the AUC of FAR (0.911, 95%CI: 0. 842 - 0.980) was higher than NLR (0.697, 95%CI: 0.574 - 0.821), PLR (0.695, 95%CI: 0.571 - 0.820), MLR (0.553, 95%CI: 0.415 - 0.691), fibrinogen (0.718, 95%CI: 0.590 - 0.847), CRP (0.672, 95%CI: 0.540 - 0.803), ESR (0.640, 95%CI: 0.510 - 0.770), C3 (0.644, 95%CI: 0.515 - 0.773), C4 (0.544, 95%CI: 0.407 - 0.681) and albumin (0.894, 95%CI: 0.819 - 0.969). FAR was positively correlated with SLEDAI-2K (r = 0.682, P < 0.001), yielding a highest relevance than other inflammatory parameters.Conclusion:FAR was significantly elevated in SLE patients compared with healthy subjects and related with the disease activity of SLE. FAR might be a useful inflammatory index to evaluate disease activity in patients with SLE.