Relationship between C-reactive Protein/Albumin Ratio and Subclinical Inflammation in Patients with Familial Mediterranean Fever

Abstract

Background Familial Mediterranean Fever (FMF), which is characterised by recurrent episodes of fever with serositis, is associated with ongoing inflammation without clinical findings during attack-free periods, leading to amyloidosis, the most important complication of FMF. The objective of this study was to investigate the C-reactive protein/albumin ratio (CAR) as a marker to identify subclinical inflammation in symptom-free FMF children and compare the CAR with other systemic inflammatory markers such as mean platelet volume (MPV), red cell distribution width (RDW), neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR).

Material and Methods We included 100 patients and 70 healthy subjects. Hospital records were obtained to collect data on laboratory findings and genetic mutations.

Results We found that the CAR levels of our FMF patients were significantly higher than those of the control group. We also evaluated that the CAR values had a higher area-under-the-curve value than the other systemic inflammation parameters including CRP, MPV, RDW, NLR, PLR based on Receiver-Operating Characteristics (ROC) analysis.

Conclusion It is important to identify subclinical inflammation in FMF patients with simple, reliable, easily accessible markers to avoid amyloidosis. Although the CAR might be used to assess subclinical inflammation in paediatric FMF patients, the prognostic value of CAR is not superior to CRP. Merging CRP and albumin into a single index thus provides no additional benefit in detecting subclinical inflammation in FMF.

Zusammenfassung

Hintergrund Das familiäre Mittelmeerfieber (FMF), gekennzeichnet durch wiederkehrende Fieberschübe mit Serositis, weist im anfallsfreien Intervall kontinuierliche Entzündungen ohne klinische Befunde auf und führt zu Amyloidose, der Hauptkomplikation von FMF. Ziel dieser Studie war die Untersuchung des C-reaktiven Proteins/Albumin-Quotienten (CAR) als Marker zur Identifizierung subklinischer Entzündungen bei Kindern ohne FMF-Symptome und der Vergleich des CAR mit den anderen identifizierten Entzündungsmarkern wie mittleres Thrombozytenvolumen (MPV), Erythrozytenbreitenverteilung (RDW), Neutrophilen/Lymphozyten-Verhältnis (NLR) und Thrombozyten/Lymphozyten-Verhältnis (PLR).

Testmaterial und -methoden Wir bezogen 100 Patienten und 70 gesunde Probanden ein. Krankenhausdaten wurden erstellt, um Daten über Laborbefunde und genetische Mutationen zu sammeln.

Ergebnisse Wir stellten fest, dass die CAR-Werte unserer FMF-Patienten signifikant höher waren als die der Kontrollgruppe. Wir bewerteten auch, dass die CAR-Werte eine höhere Fläche unter dem Kurvenwert hatten als die anderen systemischen Entzündungsparameter, einschließlich CRP, MPV, RDW, NLR, PLR, basierend auf der ROC-Analyse (Receiver-Operating Characteristics).

Schlussfolgerung Es ist wichtig, subklinische Entzündungen bei FMF-Patienten mit einfachen, zuverlässigen, leicht zugänglichen Markern zu identifizieren, um Amyloidose zu vermeiden. Obwohl CAR zur Beurteilung subklinischer Entzündungen bei pädiatrischen FMF-Patienten eingesetzt werden könnte, ist der prognostische Wert des CAR dem CRP nicht überlegen. Die Kombination von CRP und Albumin zu einem einzigen Index bietet daher keinen zusätzlichen Vorteil bei der Erkennung subklinischer Entzündungen bei FMF.

Key words

albumin - C-reactive protein - Familial Mediterranean Fever - subclinical inflammation

Schlüsselwörter

Albumin - C-reaktives Protein - Familiäres Mittelmeerfieber - subklinische Entzündung

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