AB0528 CORRELATION BETWEEN ALBUMIN TO GLOBULIN RATIO AND DISEASE ACTIVITY IN SYSTEMIC LUPUS ERYTHEMATOSUS

Abstract

BackgroundNeutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) have been reported as useful inflammatory biomarkers associated with the disease activity of systemic lupus erythematosus (SLE). Recently, the albumin to globulin ratio (AGR) has emerged as a potential indicator to predict the prognosis of some cancers. However, whether AGR can predict the disease activity of SLE has been rarely investigated.ObjectivesThis study was to explore the relation between AGR and SLE Disease Activity Index 2000 (SLEDAI-2K) in patients with SLE.MethodsThis retrospective study enrolled 101 SLE patients and 75 age- and gender-matched healthy individuals. According to the SLEDAI-2K score, SLE patients were classified into Group 1 with a score of 9 or lower (patients with mild disease activity, N = 60) and Group 2 with a score > 9 (patients with moderate to severe disease activity, N = 41). Albumin, globulin, NLR, PLR, monocyte to lymphocyte ratio (MLR), AGR, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), complement 3 (C3), complement 4 (C4), SLEDAI-2K and other clinical data 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 checked. The prognostic value of AGR in the SLE disease activity was tested by logistical regression analyses.ResultsAlbumin and AGR in SLE patients were lower compared to those of the healthy controls (P < 0.05), while NLR, PLR, MLR, globulin and CRP were higher (P < 0.05). Patients in Group 2 had lower levels of albumin, AGR, C3 and C4 than those in Group 1 (P < 0.05), NLR and PLR were higher (P < 0.05), while MLR (P = 0.198), globulin (P = 0.704), CRP (P = 0.224) and ESR (P = 0.135) displayed no significant differences. The ROC curves for differentiating SLE patients from healthy individuals showed that the area under curve (AUC) of AGR (0.812, 95%CI: 0.750 - 0.874) and albumin (0.840, 95%CI: 0.782 - 0.898) were higher than NLR (0.786, 95%CI: 0.719 - 0.853), PLR (0.708, 95%CI: 0.629 - 0.786), MLR (0.776, 95%CI: 0.708 - 0.845) and globulin (0.630, 95%CI: 0.548 - 0.713). Similarly, the ROC curves for predicting the disease activity of SLE patients displayed that the AUC of AGR (0.779, 95%CI: 0.689 - 0.870) and albumin (0.827, 95%CI: 0.746 - 0.909) were also higher than NLR (0.644, 95%CI: 0.534 - 0.753), PLR (0.672, 95%CI: 0.565 - 0.780), MLR (0.583, 95%CI: 0.466 - 0.701), globulin (0.521, 95%CI: 0.403 - 0.639), CRP (0.567, 95%CI: 0.452 - 0.683), ESR (0.589, 95%CI: 0.475 - 0.703), C3 (0.709, 95%CI: 0.603 - 0.815) and C4 (0.655, 95%CI: 0.542 - 0.768). AGR was negatively correlated with SLEDAI-2K (r = -0.543, P < 0.001) in SLE patients. Logistical regression analyses showed that AGR (OR = 13.047, 95%CI: 3.407 - 49.966, P < 0.001) was an inverse predictor for SLE disease activity, yielding a highest hazard than other inflammatory parameters.ConclusionAGR was significantly decreased in SLE patients compared with healthy subjects and negatively associated with the disease activity of SLE. AGR might be a potential indicator for evaluating inflammation in patients with SLE.References[1]Zhang Y, Wang L, Lin S, et al. Preoperative albumin-to-globulin ratio as a significant prognostic indicator in urologic cancers: a meta-analysis[J]. Cancer Manag Res, 2018,10:4695-4708.Disclosure of InterestsNone declared