Circulating C-Reactive Protein to Prealbumin Ratio and Prealbumin to Fibrinogen Ratio are Two Promising Inflammatory Markers Associated with Disease Activity in Rheumatoid Arthritis.

Background: The C-reactive protein to prealbumin ratio (CPR) and prealbumin to fibrinogen ratio (PFR) are two new inflammatory markers that were reported to have predictive value for the assessment of systemic inflammatory disease. The aim of the present study was to explore the relationship between these two markers and the Disease Activity Score of 28 joints (DAS-28) in rheumatoid arthritis (RA). Methods: A total of 170 RA patients and 120 healthy individuals were enrolled in this retrospective study. Correlations of CPR and PFR with the disease activity of RA were analyzed. Receiver-operating characteristic (ROC) curves for CPR and PFR were generated to determine the discriminative ability by calculating the areas under the curve (AUC). Results: Compared with healthy controls, RA patients showed a significantly lower PFR (p < 0.001) and higher CPR (p < 0.001). CPR was positively correlated with C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and DAS-28 score (r = 0.957, p < 0.001, r = 0.781, p < 0.001, r = 0.729, p < 0.001, respectively), whereas the PFR was negatively correlated with CRP, ESR, and DAS-28 score (r = -0.817, p < 0.001, r = -0.805, p < 0.001, r = -0.739, p < 0.001, respectively) in RA patients. ROC curve analysis showed that the CPR and PFR had a high level of AUC (AUC = 0.943 and AUC = 0.912, respectively). Conclusions: The CPR and PFR are two promising novel inflammatory markers for assessing disease activity in RA patients.