Evaluation of the serum C-reactive protein-albumin ratio and its relationship with disease severity in alopecia areata: A prospective case-control study.

BACKGROUND: Alopecia areata (AA) is an autoimmune and inflammatory disease characterized by localized or diffuse non-scarring hair loss . The serum C-reactive protein (CRP)/albumin ratio (CAR) is a novel inflammatory marker and a significant prognostic indicator in several diseases.

AIM: We aimed to explore CAR in AA patients and healthy controls and analyze the possible correlation between CAR and disease severity.

METHOD: The present study was conducted with 65 eligible AA patients and 65 age- and gender-matched healthy controls. Disease severity was analyzed based on the Severity of Alopecia Tool (SALT) score. The CAR score was calculated by dividing serum CRP by the albumin content in both patient and healthy control groups.

FINDINGS: 56.9% of the patients were male and 43.1% were female, and the mean age was 31.93±9.67. The patient group mean CAR level (0.42 ± 0.3) was statistically higher than that of the healthy controls (0.07±0.04), (p<0.05). There were positive correlations between disease severity, CAR (r=0.65; p<0.01), and CRP (r=0.66; p<0.01), while the correlation between disease severity and albumin was negative (r=-0.56; p<0.01). In the receiver operating characteristic analysis conducted on disease severity, the area under the curve was 0.16 for albumin, 0.92 for CRP, and 0.95 for CAR. The optimum CAR for AA severity was 0.38 with 87% sensitivity and 92% specificity.

CONCLUSION: In the study, we determined that the CAR was higher in AA patients when compared to the control group, and the elevation was associated with disease severity. The present study findings demonstrated that alopecia areata was associated with systemic inflammation, and CAR is a useful inflammatory marker in AA patients.