The role of fibrinogen to albumin ratio in patients with systemic lupus erythematosus: Relation with disease characteristics

Abstract

Aim of the work

to investigate the role of fibrinogen to albumin ratio (FAR) in systemic lupus erythematosus (SLE) patients and its relationship with disease characteristics.

Patients and methods

This study included 45 SLE patients with activity and another 45 without as well as 45 controls. The clinical, laboratory data including FAR measurement and SLE disease activity index 2000 (SLEDAI-2K) were assessed.

Results

The patients were 83.3% females, with a median (IQR) age of 30.5 (23–41) years and disease duration of 4 (2–7) years. The median FAR value was significantly higher in patients (1.4, 0.6–1.8) compared to control (0.6, 0.5–0.8) and in active (1.6, 1.2–2.1) compared to inactive (0.7, 0.5–1.7) patients (both p< 0.0001). Higher FAR values were significantly associated with receiving disease modifying antirheumatic drugs (DMARDs) (n= 82) (1.4, 0.7–2 vs 0.4, 0.15–1.1) (p= 0.01). FAR significantly correlated with the erythrocyte sedimentation rate (ESR) (r= 0.3, p= 0.004), anti-double stranded deoxyribonucleic acid (anti-dsDNA) (r= 0.28, p= 0.008) and urinary protein/creatinine (r= 0.48, p< 0.0001) while inversely with complement (C3: r= -0.41, p< 0.0001 and C4: r= -0.31, p= 0.003). Anti-dsDNA was the most significant factor affecting the values of FAR (β= 0.24, p= 0.04). The best cut-off value of FAR to discriminate SLE from controls and active from inactive patients were 1.1 and 0.8, with a diagnostic sensitivity of 58.9% and 86.7% and specificity of 95.6% and 55.6%, p< 0001 and p< 0.001, respectively.

Conclusion

The FAR was significantly increased in SLE patients and was linked with disease activity particularly renal. FAR can be used as an inflammatory biomarker to monitor SLE disease activity.