Evaluation of Neutrophils to Albumin Ratio (NAR) and C-Reactive Protein to Albumin Ratio (CAR) as Markers of Disease Activity in Patients with Ulcerative Colitis

Doaa Salah Abd-EL-Fattah, Department of Tropical Medicine, Faculty of Medicine, Mansoura University, EgyptFollow
Mohamed Abd El-Maksoud, Department of Tropical Medicine, Faculty of Medicine, Mansoura University, Egypt
Salwa M. Abo El-Khair, Department of Medical Biochemistry and Molecular Biology, Faculty of Medicine, Mansoura University Egypt
Ahmed El-Eraky, Department of Tropical Medicine, Faculty of Medicine, Mansoura University, Egypt
Amany Hasson, Department of Tropical Medicine, Faculty of Medicine, Mansoura University, Egypt

Corresponding Author

Doaa Salah Abd-EL-Fattah

Subject Area

Tropical Medicine

Article Type

Original Study

Abstract

Background Ulcerative colitis (UC) is considered an extensive disease due to the risks of proximal extension, malignant transformation, disability and impaired life quality. This study aimed to explore the role of Neutrophils to Albumin Ratio (NAR) and C - reactive protein to Albumin Ratio (CAR) in evaluation of disease activity in patients with UC. Methods This cross-sectional study included 227subjects classified into two groups; group (I) included 126patients suffering from ulcerative colitis and group (II) included 101 healthy individuals with normal basic laboratory tests matched for age and sex. Estimating disease activity and severity clinically was according to Truelove criteria. UC patients were assessed by Mayo Endoscopic Sub-score to determine disease severity and by Montreal classification to determine disease extent. Histopathological evaluation was done. Neutrophils to Albumin Ratio (NAR) and CAR were assessed. Results NAR and CAR were significantly higher in UC patients compared to controls, indicating their potential diagnostic value. CAR and NAR showed significant positive correlations with clinical (Truelove score) and endoscopic (Mayo score) disease activity, as well as with histopathological severity, whereas NAR also correlated with the Montreal classification. ROC curve analysis revealed fair diagnostic performance of CAR and NAR in differentiating UC patients from healthy controls, with CAR showing highest sensitivity (76.2%) and NAR showing highest specificity (73.3%) at optimal cut-off values. Conclusion We concluded that CAR and NAR are simple, non-invasive, cost-effective markers that may be useful in assessing disease activity and aiding UC diagnosis. CAR and NAR can provide valuable complementary information in settings with limited resources.

Recommended Citation

Abd-EL-Fattah, Doaa Salah; El-Maksoud, Mohamed Abd; El-Khair, Salwa M. Abo; El-Eraky, Ahmed; and Hasson, Amany (2026) "Evaluation of Neutrophils to Albumin Ratio (NAR) and C-Reactive Protein to Albumin Ratio (CAR) as Markers of Disease Activity in Patients with Ulcerative Colitis," Mansoura Medical Journal: Vol. 55 : Iss. 2 , Article 7.
Available at: https://doi.org/10.58775/2735-3990.1518