Background: Albumin and derived neutrophil to lymphocyte ratio (dNLR) are known biomarkers that can reflect
systemic inflammation and it has been hypothesized that combination of both markers in one score (albumin-dNLR
score) can be useful in monitoring rheumatoid arthritis (RA) patients. The current study intended to measure
albumin -dNLR score in patients with RA in the order to find whether these new biomarkers could reflect the
activity of the disease and the articular activity detected by ultrasonography. We measured serum albumin and
dNLR in blood samples obtained from 100 RA patients and from 100 apparently healthy controls (HC). Albumin
-dNLR score was calculated according to the presence of hypoalbuminemia (≤ 3.76 gm/dl) and/or raised dNLR
(>1.37).
Results: RA patients had a significantly elevated dNLR (p< 0.001) and albumin-dNLR score (p< 0.001) compared to
their levels in HC, while serum albumin was significantly decreased (p< 0.001) in RA patients than its level in HC. In
RA patients, albumin-dNLR score correlated significantly with DAS28 (p< 0.001), erythrocyte sedimentation rate (ESR)
(p< 0.001), C-reactive protein (p< 0.001), grey scale (p< 0.001), power Doppler (p< 0.001) and total ultrasound score
(p< 0.001). Also, tender joint count, ESR and albumin-dNLR score were significant predictors of DAS28 in
multivariate regression analysis.
Conclusions: Our study settled that albumin - dNLR score is increased in RA patients than in healthy subjects. The
score correlated well with DAS28, acute phase reactants, and ultrasonographic synovitis scores implying that it
could be an easy valuable biomarker to monitor RA disease activity |
