.: ORİJİNAL ARAŞTIRMA
Vitiligo Hastalarında Serum C-Reaktif Protein/Albumin Oranının Değerlendirilmesi: Retrospektif Vaka Kontrol Çalışması
Assessment of the Serum C-Reactive Protein/Albumin Ratio in Patients with Vitiligo: A Retrospective Case-Control Study
Turkiye Klinikleri J Dermatol. 2023;33(2):60-6
doi: 10.5336/dermato.2022-94816
Makale Dili: TR
Tam Metin
ÖZET
Amaç: Vitiligo etiyopatogenezinde sistemik inflamasyon önemli rol oynar. Birçok inflamatuar hastalık için serum C-reaktif protein (CRP)/albumin oranı [C-reactive protein/albumin ratio (CAR)] prognostik belirteç olarak bildirilmektedir. Vitiligo hastalarında ve sağlıklı kontrollerde CAR değerinin belirlenerek, vitiligo şiddeti ve aktivitesi ile ilişkisinin araştırılmasını amaçladık. Gereç ve Yöntemler: Hastanemizde vitiligo tanısı konulmuş 78 hasta ile benzer yaş ve cinsiyette 78 sağlıklı kontrol retrospektif olarak çalışmaya alındı. Hastalık şiddetini belirlemek için Vitiligo Alan ve Şiddet İndeksi kullanıldı. Vitiligo Hastalık Aktivite Skoru [Vitiligo Disease Activity Score (VIDA)] baz alınarak, hastalar aktif ve stabil olarak 2 grupta incelendi. Hasta ve kontrol grubu için serum CRP ve serum albumin değerleri oranlanarak CAR değeri hesaplandı. Bulgular: Çalışmadaki 78 hastanın 30'u (%38) erkek, 48'i (%62) kadın; yaş ortalaması 33±8,9 idi. Kontrol grubunun 32'si (%41) erkek, 46'sı (%59) kadın; yaş ortalaması 35,8±9,7 idi (p>0,05). Serum CRP düzeyi hasta grubunda ortalama 0,82±0,44 mg/dL iken, sağlıklı kontrollerde 0,31±0,17 mg/dL olarak bulundu (p=0,001). Ortalama CAR değeri hasta grubunda 0,21±0,12, sağlıklı kontrollerde 0,07±0,04 olarak bulundu (p=0,001). VIDA skoru ile CAR değeri (r=0,54; p<0,01) arasında ve VIDA skoru ile CRP değeri (r=0,47; p<0,01) arasında pozitif korelasyon mevcuttu. CAR için kesme değeri (cut off) %78 sensitivite ve %80 spesifite ile 0,2 idi. Sonuç: CAR değeri, vitiligoda sistemik inflamasyonun ve hastalık aktivitesinin bir göstergesi olabilir.
Anahtar Kelimeler: Vitiligo; C-reaktif protein; albumin; C-reaktif protein/albumin oranı
Amaç: Vitiligo etiyopatogenezinde sistemik inflamasyon önemli rol oynar. Birçok inflamatuar hastalık için serum C-reaktif protein (CRP)/albumin oranı [C-reactive protein/albumin ratio (CAR)] prognostik belirteç olarak bildirilmektedir. Vitiligo hastalarında ve sağlıklı kontrollerde CAR değerinin belirlenerek, vitiligo şiddeti ve aktivitesi ile ilişkisinin araştırılmasını amaçladık. Gereç ve Yöntemler: Hastanemizde vitiligo tanısı konulmuş 78 hasta ile benzer yaş ve cinsiyette 78 sağlıklı kontrol retrospektif olarak çalışmaya alındı. Hastalık şiddetini belirlemek için Vitiligo Alan ve Şiddet İndeksi kullanıldı. Vitiligo Hastalık Aktivite Skoru [Vitiligo Disease Activity Score (VIDA)] baz alınarak, hastalar aktif ve stabil olarak 2 grupta incelendi. Hasta ve kontrol grubu için serum CRP ve serum albumin değerleri oranlanarak CAR değeri hesaplandı. Bulgular: Çalışmadaki 78 hastanın 30'u (%38) erkek, 48'i (%62) kadın; yaş ortalaması 33±8,9 idi. Kontrol grubunun 32'si (%41) erkek, 46'sı (%59) kadın; yaş ortalaması 35,8±9,7 idi (p>0,05). Serum CRP düzeyi hasta grubunda ortalama 0,82±0,44 mg/dL iken, sağlıklı kontrollerde 0,31±0,17 mg/dL olarak bulundu (p=0,001). Ortalama CAR değeri hasta grubunda 0,21±0,12, sağlıklı kontrollerde 0,07±0,04 olarak bulundu (p=0,001). VIDA skoru ile CAR değeri (r=0,54; p<0,01) arasında ve VIDA skoru ile CRP değeri (r=0,47; p<0,01) arasında pozitif korelasyon mevcuttu. CAR için kesme değeri (cut off) %78 sensitivite ve %80 spesifite ile 0,2 idi. Sonuç: CAR değeri, vitiligoda sistemik inflamasyonun ve hastalık aktivitesinin bir göstergesi olabilir.
Anahtar Kelimeler: Vitiligo; C-reaktif protein; albumin; C-reaktif protein/albumin oranı
ABSTRACT
Objective: Systemic inflammation plays a significant role in the etiopathogenesis of vitiligo. The serum C-reactive protein (CRP)/albumin ratio (CAR) has been reported as an important prognostic marker in many inflammatory diseases. To determine the CAR value in patients with vitiligo and healthy controls and investigate the relationship of this parameter with vitiligo severity and activity. Material and Methods: Seventy-eight patients diagnosed with vitiligo in our hospital and 78 age- and gender-matched healthy controls were retrospectively included in the study. Disease severity was assessed using the Vitiligo Area and Severity Index. The Vitiligo Disease Activity Score (VIDA) was used to determine disease activity. The CAR value was calculated by dividing the serum CRP values by the serum albumin values for the patient and control groups. Results: Of the 78 patients with vitiligo in these study, 30 (38%) were male and 48 (62%) were female, and their mean age was 33±8.9 years. In the healthy controls, 32 (41%) participants were male and 46 (59%) were female, with a mean age of 35.8±9.7 years (p>0.05). The serum CRP level was mean 0.82±0.44 mg/dL in the vitiligo group and 0.31±0.17 mg/dL in the controls (p=0.001). The mean CAR values of the vitiligo was 0.21±0.12 and healthy controls was 0.07±0.04 (p=0.001). A positive correlation was observed between the VIDA score and CAR (r=0.54; p<0.01) and CRP (r=0.47; p<0.01). The CAR cut-off value was calculated as 0.2 with 78% sensitivity and 80% specificity. Conclusion: The CAR value may be indicative of systemic inflammation and disease activity in vitiligo.
Keywords: Vitiligo; C-reactive protein; albumin; C-reactive protein/albumin ratio
Objective: Systemic inflammation plays a significant role in the etiopathogenesis of vitiligo. The serum C-reactive protein (CRP)/albumin ratio (CAR) has been reported as an important prognostic marker in many inflammatory diseases. To determine the CAR value in patients with vitiligo and healthy controls and investigate the relationship of this parameter with vitiligo severity and activity. Material and Methods: Seventy-eight patients diagnosed with vitiligo in our hospital and 78 age- and gender-matched healthy controls were retrospectively included in the study. Disease severity was assessed using the Vitiligo Area and Severity Index. The Vitiligo Disease Activity Score (VIDA) was used to determine disease activity. The CAR value was calculated by dividing the serum CRP values by the serum albumin values for the patient and control groups. Results: Of the 78 patients with vitiligo in these study, 30 (38%) were male and 48 (62%) were female, and their mean age was 33±8.9 years. In the healthy controls, 32 (41%) participants were male and 46 (59%) were female, with a mean age of 35.8±9.7 years (p>0.05). The serum CRP level was mean 0.82±0.44 mg/dL in the vitiligo group and 0.31±0.17 mg/dL in the controls (p=0.001). The mean CAR values of the vitiligo was 0.21±0.12 and healthy controls was 0.07±0.04 (p=0.001). A positive correlation was observed between the VIDA score and CAR (r=0.54; p<0.01) and CRP (r=0.47; p<0.01). The CAR cut-off value was calculated as 0.2 with 78% sensitivity and 80% specificity. Conclusion: The CAR value may be indicative of systemic inflammation and disease activity in vitiligo.
Keywords: Vitiligo; C-reactive protein; albumin; C-reactive protein/albumin ratio
REFERANSLAR:
- Alikhan A, Felsten LM, Daly M, Petronic-Rosic V. Vitiligo: a comprehensive overview Part I. Introduction, epidemiology, quality of life, diagnosis, differential diagnosis, associations, histopathology, etiology, and work-up. J Am Acad Dermatol. 2011;65(3):473-91. [Crossref] [PubMed]
- Taïeb A, Picardo M; VETF Members. The definition and assessment of vitiligo: a consensus report of the Vitiligo European Task Force. Pigment Cell Res. 2007;20(1):27-35. [Crossref] [PubMed]
- Halder RM, Chappell JL. Vitiligo update. Semin Cutan Med Surg. 2009;28(2):86-92. [Crossref] [PubMed]
- Sandoval-Cruz M, García-Carrasco M, Sánchez-Porras R, Mendoza-Pinto C, Jiménez-Hernández M, Munguía-Realpozo P, et al. Immunopathogenesis of vitiligo. Autoimmun Rev. 2011;10(12):762-5. [Crossref] [PubMed]
- Zhen Y, Yao L, Zhong S, Song Y, Cui Y, Li S. Enhanced Th1 and Th17 responses in peripheral blood in active non-segmental vitiligo. Arch Dermatol Res. 2016;308(10):703-10. [Crossref] [PubMed]
- Solak B, Dikicier BS, Cosansu NC, Erdem T. Neutrophil to lymphocyte ratio in patients with vitiligo. Postepy Dermatol Alergol. 2017;34(5):468-70. [Crossref] [PubMed] [PMC]
- Yasmin T, Aya B, Amal H, Amira K, Ahmed G. Serum interleukin-22 and C-reactive protein in patients with vitiligo: a case-control study on 35 Egyptian patients. Egypt J Dermatol Venerol. 2021;41(1):32-7. [Crossref]
- Hamzavi I, Jain H, McLean D, Shapiro J, Zeng H, Lui H. Parametric modeling of narrowband UV-B phototherapy for vitiligo using a novel quantitative tool: the Vitiligo Area Scoring Index. Arch Dermatol. 2004;140(6):677-83. [Crossref] [PubMed]
- Njoo MD, Das PK, Bos JD, Westerhof W. Association of the Köbner phenomenon with disease activity and therapeutic responsiveness in vitiligo vulgaris. Arch Dermatol. 1999;135(4):407-13. [Crossref] [PubMed]
- Demirbaş A, Elmas ÖF, Atasoy M, Türsen Ü, Lotti T. Can monocyte to HDL cholesterol ratio and monocyte to lymphocyte ratio be markers for inflammation and oxidative stress in patients with vitiligo? A preliminary study. Arch Dermatol Res. 2021;313(6):491-8. [Crossref] [PubMed]
- Acharya P, Mathur M. Interleukin-17 level in patients with vitiligo: A systematic review and meta-analysis. Australas J Dermatol. 2020;61(2):e208-e12. [Crossref] [PubMed]
- Tomaszewska K, Kozłowska M, Kaszuba A, Lesiak A, Narbutt J, Zalewska-Janowska A. Increased serum levels of IFN-γ, IL-1β, and IL-6 in patients with alopecia areata and nonsegmental vitiligo. Oxid Med Cell Longev. 2020;2020:5693572. [Crossref] [PubMed] [PMC]
- Castell JV, Gómez-Lechón MJ, David M, Fabra R, Trullenque R, Heinrich PC. Acute-phase response of human hepatocytes: regulation of acute-phase protein synthesis by interleukin-6. Hepatology. 1990;12(5):1179-86. [Crossref] [PubMed]
- Holt I, Cooper RG, Hopkins SJ. Relationships between local inflammation, interleukin-6 concentration and the acute phase protein response in arthritis patients. Eur J Clin Invest. 1991;21(5):479-84. [Crossref] [PubMed]
- Póvoa P, Coelho L, Almeida E, Fernandes A, Mealha R, Moreira P, et al. C-reactive protein as a marker of infection in critically ill patients. Clin Microbiol Infect. 2005;11(2):101-8. [Crossref] [PubMed]
- Pepys MB, Hirschfield GM. C-reactive protein: a critical update. J Clin Invest. 2003;111(12):1805-12. Erratum in: J Clin Invest. 2003;112(2):299. [Crossref] [PubMed] [PMC]
- Beygi S, Lajevardi V, Abedini R. C-reactive protein in psoriasis: a review of the literature. J Eur Acad Dermatol Venereol. 2014;28(6):700-11. [Crossref] [PubMed]
- Georgescu SR, Ene CD, Tampa M, Matei C, Benea V, Nicolae I. Oxidative stress- related markers and alopecia areata through latex turbidimetric immunoassay method. Mater. Plast. 2016;53(3):522-6. [Link]
- Vekaria AS, Brunner PM, Aleisa AI, Bonomo L, Lebwohl MG, Israel A, et al. Moderate-to-severe atopic dermatitis patients show increases in serum C-reactive protein levels, correlating with skin disease activity. F1000Res. 2017;6:1712. [Crossref] [PubMed] [PMC]
- Don BR, Kaysen G. Serum albumin: relationship to inflammation and nutrition. Semin Dial. 2004;17(6):432-7. [Crossref] [PubMed]
- Cabrerizo S, Cuadras D, Gomez-Busto F, Artaza-Artabe I, Marín-Ciancas F, Malafarina V. Serum albumin and health in older people: Review and meta analysis. Maturitas. 2015;81(1):17-27. [Crossref] [PubMed]
- Alves FC, Sun J, Qureshi AR, Dai L, Snaedal S, Bárány P, et al. The higher mortality associated with low serum albumin is dependent on systemic inflammation in end-stage kidney disease. PLoS One. 2018;13(1):e0190410. [Crossref] [PubMed] [PMC]
- Sheikh G, Masood Q, Majeed S, Hassan I. Comparison of levels of serum copper, zinc, albumin, globulin and alkaline phosphatase in psoriatic patients and controls: A hospital based casecontrol study. Indian Dermatol Online J. 2015;6(2):81-3. [Crossref] [PubMed] [PMC]
- Li WC, Mo LJ, Shi X, Lin ZY, Li YY, Yang Z, et al. Antioxidant status of serum bilirubin, uric acid and albumin in pemphigus vulgaris. Clin Exp Dermatol. 2018;43(2):158-63. [Crossref] [PubMed]
- Park JE, Chung KS, Song JH, Kim SY, Kim EY, Jung JY, et al. The C-reactive protein/albumin ratio as a predictor of mortality in critically ill patients. J Clin Med. 2018;7(10):333. [Crossref] [PubMed] [PMC]
- Ranzani OT, Zampieri FG, Forte DN, Azevedo LC, Park M. C-reactive protein/albumin ratio predicts 90-day mortality of septic patients. PLoS One. 2013;8(3):e59321. [Crossref] [PubMed] [PMC]
- Fu YJ, Li KZ, Bai JH, Liang ZQ. C-reactive protein/albumin ratio is a prognostic indicator in Asians with pancreatic cancers: A meta-analysis. Medicine (Baltimore). 2019;98(48):e18219. [Crossref] [PubMed] [PMC]
- Ishizuka M, Nagata H, Takagi K, Iwasaki Y, Shibuya N, Kubota K. Clinical significance of the c-reactive protein to albumin ratio for survival after surgery for colorectal cancer. Ann Surg Oncol. 2016;23(3):900-7. [Crossref] [PubMed]
- Ni XF, Wu J, Ji M, Shao YJ, Xu B, Jiang JT, et al. Effect of C-reactive protein/albumin ratio on prognosis in advanced non-small-cell lung cancer. Asia Pac J Clin Oncol. 2018;14(6):402-9. [Crossref] [PubMed]
- Qin G, Tu J, Liu L, Luo L, Wu J, Tao L, et al. Serum albumin and c-reactive protein/albumin ratio are useful biomarkers of crohn's disease activity. Med Sci Monit. 2016;22:4393-400. [Crossref] [PubMed]
- Slouma M, Rahmouni S, Dhahri R, Gharsallah I, Metoui L, Louzir B. Neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, c-reactive protein to albumin ratio, and albumin to fibrinogen ratio in axial spondyloarthritis: a monocentric study. Curr Rheumatol Rev. 2021;17(3):312-7. [Crossref] [PubMed]
- Seringec Akkececi N, Yildirim Cetin G, Gogebakan H, Acipayam C. The c-reactive protein/albumin ratio and complete blood count parameters as indicators of disease activity in patients with Takayasu Arteritis. Med Sci Monit. 2019;25:1401-9. [Crossref] [PubMed] [PMC]
- Kayabasi S, Hizli O, Cayir S. A novel predictor parameter for active recurrent aphthous stomatitis: c-reactive protein to albumin ratio. Cureus. 2019;11(10):e5965. [Crossref] [PubMed] [PMC]
- Kemeriz F, Tuğrul B, Tuncer SÇ. C-reactive protein to albumin ratio: Is a new parameter for the disease severity in patients with psoriasis vulgaris? Dermatologica Sinica. 2020;38(4):199-204. [Crossref]
- Tamer F, Avcı E. Serum C-reactive protein to albumin ratio as a novel inflammation biomarker in psoriasis patients treated with adalimumab, ustekinumab, infliximab, and secukinumab: a retrospective study. Croat Med J. 2020;61(4):333-7. [Crossref] [PubMed] [PMC]
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