Does the LDH/Albumin Ratio Bring Novelty? A Comparative Analysis with Inflammatory Indices and Combined Models in Adult-Onset Still’s Disease
Background/Objectives: The objective of this study was to evaluate the diagnostic accuracy of the lactate dehydrogenase-to-albumin ratio (LAR) in adult-onset Still’s disease (AOSD) and compare it with other inflammatory indices, using patients with fever of unknown origin (FUO) as a control group du...
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2024-12-01
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| author | Ali Ekin Salim Mısırcı Hikmet Öztop Asuman Şebnem Hacımustafaoğlu Belkıs Nihan Coşkun Burcu Yağız Ediz Dalkılıç Yavuz Pehlivan |
| author_facet | Ali Ekin Salim Mısırcı Hikmet Öztop Asuman Şebnem Hacımustafaoğlu Belkıs Nihan Coşkun Burcu Yağız Ediz Dalkılıç Yavuz Pehlivan |
| author_sort | Ali Ekin |
| collection | DOAJ |
| description | Background/Objectives: The objective of this study was to evaluate the diagnostic accuracy of the lactate dehydrogenase-to-albumin ratio (LAR) in adult-onset Still’s disease (AOSD) and compare it with other inflammatory indices, using patients with fever of unknown origin (FUO) as a control group due to their overlapping clinical features with AOSD. The study also compared LAR’s diagnostic performance with other inflammatory indices like the serum immune-inflammatory index (SII), ferritin/erythrocyte sedimentation rate (FER), CRP/albumin ratio (CAR), platelet/lymphocyte ratio (PLR), and neutrophil/lymphocyte ratio (NLR), as well as its combinations with FER, PLR, and ferritin (LAR + FER, LAR + PLR, LAR + ferritin). Methods: A retrospective evaluation was conducted on 70 patients with fever of unknown cause and 78 patients with AOSD, admitted between January 2000 and December 2023 in a tertiary care hospital. Demographic, clinical, and laboratory characteristics were compared between the groups. ROC analysis provided cutoff values, sensitivity, and specificity for each inflammatory index. Results: ROC analysis showed significant <i>p</i>-values (<i>p</i> < 0.05) for indices other than LAR (<i>p</i> = 0.090) LAR + PLR (<i>p</i> = 0.806), and PLR (<i>p</i> = 0.634) in diagnosing AOSD. The highest specificity was found in LAR + ferritin (92.90%), and the highest sensitivity in CAR (100.0%). NLR, SII, FER, and LAR + FER were the indices with both sensitivity and specificity above 50%. LAR had a sensitivity of 76.90% and a specificity of 48.60%. The cutoff values were 3978.0 µg/L for ferritin and 70.98 for LAR. Significant statistical differences between AOSD and non-AOSD groups were observed for all indices except CAR (<i>p</i> = 0.133). Conclusions: LAR can differentiate AOSD patients from FUO, but its specificity is lower than most other indices. The diagnostic utility of these indices in clinical practice remains controversial. |
| format | Article |
| id | doaj-art-5a3f3a1140424422b152c59a11b4862f |
| institution | Kabale University |
| issn | 2075-4418 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | MDPI AG |
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| series | Diagnostics |
| spelling | doaj-art-5a3f3a1140424422b152c59a11b4862f2024-12-27T14:20:42ZengMDPI AGDiagnostics2075-44182024-12-011424278010.3390/diagnostics14242780Does the LDH/Albumin Ratio Bring Novelty? A Comparative Analysis with Inflammatory Indices and Combined Models in Adult-Onset Still’s DiseaseAli Ekin0Salim Mısırcı1Hikmet Öztop2Asuman Şebnem Hacımustafaoğlu3Belkıs Nihan Coşkun4Burcu Yağız5Ediz Dalkılıç6Yavuz Pehlivan7Divison of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Bursa Uludag University, 16059 Bursa, TurkeyDivison of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Bursa Uludag University, 16059 Bursa, TurkeyDepartment of Internal Medicine, Faculty of Medicine, Bursa Uludag University, 16059 Bursa, TurkeyGaziantep City Hospital, 27470 Gaziantep, TurkeyDivison of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Bursa Uludag University, 16059 Bursa, TurkeyDivison of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Bursa Uludag University, 16059 Bursa, TurkeyDivison of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Bursa Uludag University, 16059 Bursa, TurkeyDivison of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Bursa Uludag University, 16059 Bursa, TurkeyBackground/Objectives: The objective of this study was to evaluate the diagnostic accuracy of the lactate dehydrogenase-to-albumin ratio (LAR) in adult-onset Still’s disease (AOSD) and compare it with other inflammatory indices, using patients with fever of unknown origin (FUO) as a control group due to their overlapping clinical features with AOSD. The study also compared LAR’s diagnostic performance with other inflammatory indices like the serum immune-inflammatory index (SII), ferritin/erythrocyte sedimentation rate (FER), CRP/albumin ratio (CAR), platelet/lymphocyte ratio (PLR), and neutrophil/lymphocyte ratio (NLR), as well as its combinations with FER, PLR, and ferritin (LAR + FER, LAR + PLR, LAR + ferritin). Methods: A retrospective evaluation was conducted on 70 patients with fever of unknown cause and 78 patients with AOSD, admitted between January 2000 and December 2023 in a tertiary care hospital. Demographic, clinical, and laboratory characteristics were compared between the groups. ROC analysis provided cutoff values, sensitivity, and specificity for each inflammatory index. Results: ROC analysis showed significant <i>p</i>-values (<i>p</i> < 0.05) for indices other than LAR (<i>p</i> = 0.090) LAR + PLR (<i>p</i> = 0.806), and PLR (<i>p</i> = 0.634) in diagnosing AOSD. The highest specificity was found in LAR + ferritin (92.90%), and the highest sensitivity in CAR (100.0%). NLR, SII, FER, and LAR + FER were the indices with both sensitivity and specificity above 50%. LAR had a sensitivity of 76.90% and a specificity of 48.60%. The cutoff values were 3978.0 µg/L for ferritin and 70.98 for LAR. Significant statistical differences between AOSD and non-AOSD groups were observed for all indices except CAR (<i>p</i> = 0.133). Conclusions: LAR can differentiate AOSD patients from FUO, but its specificity is lower than most other indices. The diagnostic utility of these indices in clinical practice remains controversial.https://www.mdpi.com/2075-4418/14/24/2780adult-onset Still’s diseasealbumininflammationfever of unknown originlactate dehydrogenase/albuminLDH |
| spellingShingle | Ali Ekin Salim Mısırcı Hikmet Öztop Asuman Şebnem Hacımustafaoğlu Belkıs Nihan Coşkun Burcu Yağız Ediz Dalkılıç Yavuz Pehlivan Does the LDH/Albumin Ratio Bring Novelty? A Comparative Analysis with Inflammatory Indices and Combined Models in Adult-Onset Still’s Disease Diagnostics adult-onset Still’s disease albumin inflammation fever of unknown origin lactate dehydrogenase/albumin LDH |
| title | Does the LDH/Albumin Ratio Bring Novelty? A Comparative Analysis with Inflammatory Indices and Combined Models in Adult-Onset Still’s Disease |
| title_full | Does the LDH/Albumin Ratio Bring Novelty? A Comparative Analysis with Inflammatory Indices and Combined Models in Adult-Onset Still’s Disease |
| title_fullStr | Does the LDH/Albumin Ratio Bring Novelty? A Comparative Analysis with Inflammatory Indices and Combined Models in Adult-Onset Still’s Disease |
| title_full_unstemmed | Does the LDH/Albumin Ratio Bring Novelty? A Comparative Analysis with Inflammatory Indices and Combined Models in Adult-Onset Still’s Disease |
| title_short | Does the LDH/Albumin Ratio Bring Novelty? A Comparative Analysis with Inflammatory Indices and Combined Models in Adult-Onset Still’s Disease |
| title_sort | does the ldh albumin ratio bring novelty a comparative analysis with inflammatory indices and combined models in adult onset still s disease |
| topic | adult-onset Still’s disease albumin inflammation fever of unknown origin lactate dehydrogenase/albumin LDH |
| url | https://www.mdpi.com/2075-4418/14/24/2780 |
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