C-reactive protein/albumin ratio is associated with lung function among children/adolescents with cystic fibrosis: a three-year longitudinal study

Abstract

BACKGROUND: Chronic lung infections, inflammation and depletion of nutritional status are considered to be prognostic indicators of morbidity in patients with cystic fibrosis. The aim of this study was to investigate the association between inflammatory markers and lung function, nutritional status and morbidity among children/adolescents with cystic fibrosis. DESIGN AND SETTINGS: Prospective three-year longitudinal study conducted in an outpatient clinic in southern Brazil. METHODS: Children/adolescents aged 1-15 years with cystic fibrosis were enrolled. Nutritional status was determined from weight-to-length and body mass index-to-age z-scores and was classified as acceptable, at risk or nutritional failure. Tumor necrosis factor-α, interleukin-1β, myeloperoxidase, C-reactive protein and C-reactive protein/albumin ratio were analyzed. Lung function was evaluated based on the forced expiratory volume in the first second and morbidity according to the number of hospitalizations for pulmonary exacerbation and infections by Pseudomonas aeruginosa . Lung function, nutritional status and morbidity were the outcomes. Odds ratios and 95% confidence intervals were to evaluate the effect of baseline inflammatory markers on the clinical outcomes after three years of follow-up and p-values < 0.05 were considered significant. RESULTS: We evaluated 38 children/adolescents with cystic fibrosis: 55% female; median age (with interquartile range), 3.75 years (2.71-7.00). Children/adolescents with high C-reactive protein/albumin ratio at baseline had odds of 18 (P = 0.018) of presenting forced expiratory volume in the first second ≤ 70% after three years. The other inflammatory markers were not associated with the outcomes. CONCLUSION: C-reactive protein/albumin ratio was associated with forced expiratory volume in the first second ≤ 70% after three years.

Lung Function in Preschool Children in Low and Middle Income Countries: An Under-Represented Potential Tool to Strengthen Child Health

“…Spirometry was also used in South American, Turkish and South African children to monitor lung function in cystic fibrosis ( 59 ), and showed good correlation between CT scan Bhalla score and FEV 1 , FVC, FEF 25−75 ( 60 ).…”

High C-reactive protein/albumin ratio increased risk of acute malnutrition during hospitalization in pediatric patients

“…Along with our knowledge, this was the first study that investigated the relationship between CRP/Albumin ratio on admission with the risk of acute malnutrition during hospitalization in pediatric patients. Other studies reported the relationship between this ratio with the prognosis and mortality rates in patients with chronic diseases and critical illness (Ventura et al, 2018;Mohamed & Elhawary, 2020;Li et al, 2017).…”

“…Several studies have reported the relationship of CRP/Albumin ratio on prognosis and mortality rates of several diseases, but not on the risk of acute malnutrition (Ventura et al, 2018;Mohamed & Elhawary, 2020;Li et al, 2017). This current study investigates the relation between CRP/Albumin ratio on admission with the risk of acute malnutrition during hospitalization in pediatric patients.…”

Serum albumin and C-reactive protein/albumin ratio in community-acquired pneumonia

“…In the presence of an infection or inflammation, CRP level increases by about 6 h and peaks at around 48 h (2,(17)(18). In CAP patients, however, the prognostic value of serum CRP level remains controversial.…”