Immune nutrition indices are associated with disease activity in rheumatoid arthritis: a cross-sectional study

This study aimed to evaluate the relationship between immune nutrition indices and disease activity in rheumatoid arthritis (RA). The current study included a cross-sectional analysis of 90 age and gender-matched healthy controls and 116 RA patients who satisfied the 2010 American College of Rheumatology and European League Against Rheumatism categorization criteria. Patients were categorized into remission (disease activity score 28- erythrocyte sedimentation rate (DAS 28-ESR) <2.6) and active disease (DAS 28-ESR ≥2.6) groups. Systemic immune-inflammatory index (SII), controlling nutritional status (CONUT), and fibrinogen-to-albumin ratio (FAR) were higher in the RA group than in controls, whereas CRP-albumin-lymphocyte ratio (CALLY) and prognostic nutrition index (PNI) were considerably lower in RA (p < 0.001). The clinical and simplified disease activity index, DAS 28-ESR had negative correlation with PNI and CALLY (p < 0.001). PNI and CALLY were independently related markers of disease activity (p < 0.001) by regression analysis. According to receiver operating characteristic curve analysis, the ideal cutoff values for the active disease are as follows: CONUT, 0.5; CALLY, 12.5, SII, 579.43, FAR, 90.43, and PNI, 40. CALLY was the most sensitive (84.06%) and specific marker (95.74%). CALLY and PNI may be useful prognostic markers for assessing disease activity in RA patients.