Association of c-reactive protein albumin ratio with disease severity and nutritional risk in patients with acute ischemic stroke

Tuğba Tatar, Fatmanur Hümeyra ZENGİN, Rümeysa Yüksel, Eda Nur Afacan

2025

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DOI 10.62210/clinscinutr.2025.120
Data confidence 70 medium
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Abstract

Background: CAR is a novel biomarker that predicts disease prognosis in inflammation-related diseases such as stroke. Aim: We aimed to evaluate the relationship between CAR and disease severity and nutritional status in patients with acute ischemic stroke (AIS). Method: This research is a cross-sectional, descriptive study. The sample consists of 99 AIS patients. A face-to-face interview questionnaire was used to determine the sociodemographic characteristics. The nutritional status was assessed by NRS-2002, SNAQ, MUST, and SGA, and disease status was determined by NIHSS and Modified Rankin Scale. Anthropometric measurements were taken. Biochemical parameters were obtained retrospectively from the patient records. Results: 21.2% (n = 21) of the patients had an NRS-2002 score ≥ 3. When the combined effect of NIHSS and MUST on CAR was evaluated using Univariate ANOVA, the main effect of both MUST and NIHSS separately was significant. However, the combined effect of NIHSS and MUST was not found (p > 0.05). CAR of those at low risk of malnutrition (6.2±13.7) was significantly lower than that of those at moderate risk of malnutrition (13.7±17.2) according to MUST (p < 0.05). NRS-2002 significantly predicted a higher CAR (B = 10.89, p = 0.002). CAR significantly predicted higher NIHSS (B = 0.02, p = 0.003). The total effect analysis showed that malnutrition was positively associated with disease severity (B = 0.72, p = 0.002). Discussion: This study revealed that nutritional risk (NRS-2002) was significantly associated with disease severity (NIHSS), both directly and indirectly. CAR mediated this relationship. Using CAR may facilitate the detection of nutritional risk.