The association between albumin-dNLR score and disease activity in patients with rheumatoid arthritis

Background: Recently, clinical studies have described an association between albumin and the derived neutrophil to lymphocyte ratio (dNLR) with several diseases. This study was aimed to investigate the albumin-dNLR (ALB-dNLR) score in rheumatoid arthritis (RA) patients and assess its relationship with clinical and laboratory parameters of RA.

Methods: We retrospectively enrolled 127 RA patients, 155 osteoarthritis (OA) patients, and 155 healthy controls. The ALB-dNLR score was based on serum albumin level, neutrophil count, and white cell count. The Spearman's rank test was used to measure the correlations between ALB-dNLR score and disease activity as well as laboratory indexes.

Results: The ALB-dNLR score was significantly higher in RA patients than in OA patients (P < 0.001) and in healthy controls (P < 0.001). The proportion of higher ALB-dNLR score has been raised along with increased disease activity (P < 0.001). The Spearman's rank test showed that ALB-dNLR score was positively associated with DAS28 score, CRP, ESR, IgA, and platelet count. Moreover, the receiver operating characteristic (ROC) curve showed that the area under the curve (AUC) of ALB-dNLR was 0.693 (95% CI: 0.631-0.755), which was higher than that of albumin (AUC: 0.625, 95% CI: 0.559-0.692) and dNLR (AUC: 0.680, 95% CI: 0.617-0.743) alone.

Conclusions: The results demonstrate that the ALB-dNLR score increased in RA patients. The ALB-dNLR score may be a useful marker to estimate the disease activity of RA patients.