Value of fibrinogen, fibrinogen to albumin ratio, and blood cell-derived inflammatory indices in patients with systemic sclerosis: A case–control study

Abstract

Introduction and objectives

Systemic sclerosis (SSc) is a rare autoimmune systemic disorder characterized by inflammation and fibrosis. Fibrinogen and C-reactive protein (CRP) are raised during inflammation. Blood cell-derived inflammatory indices are helpful for monitoring disease activity in several autoimmune diseases. In this study, we aimed to evaluate the levels of fibrinogen, fibrinogen to albumin ratio (FAR), CRP, CRP to albumin ratio (CAR), and blood cell-derived inflammatory indices in SSc patients.

Patients and methods

This observational case–control study included 31 SSc patients and 20 age- and sex-matched healthy participants. Clinical assessment was performed for SSc patients. Complete blood count, CRP, fibrinogen, and albumin were done for all study subjects with calculation of the following: CAR, FAR, lymphocyte to CRP ratio, neutrophil to lymphocyte ratio (NLR), systemic inflammation response index (SIRI), systemic immune inflammation index (SII), and prognostic nutritional index (PNI).

Results

We detected significant differences between SSc patients and healthy subjects regarding all studied variables except for albumin and PNI. Both fibrinogen and FAR were positively correlated with disease activity (P-value = .006 and .009, respectively), while NLR, SIRI, and SII were positively correlated with the modified Rodnan Skin Score (P-value = .04, .034, and .005, respectively). ROC curve analysis for active disease cutoff point detection revealed that fibrinogen had an area under the curve of 0.75 (P-value = .04) at a criterion of 3.2 with 70% sensitivity and 62% specificity.

Conclusions

Fibrinogen and FAR are reliable indicators of inflammation and disease activity in SSc patients.