Age-related differences in the association between nutritional– inflammatory indices and disease activity in rheumatoid arthritis

Authors : Selma Özlem Çelikdelen, Rümeysa Ertürk, Reyhan Bilici

Pages : 531-539

Doi:10.18663/tjcl.1807702

View : 66 | Download : 147

Publication Date : 2026-01-01

Article Type : Research Paper

Abstract :Objective: Rheumatoid arthritis (RA) is a chronic inflammatory disease in which inflammation and nutritional status jointly influence disease severity and prognosis. This study aimed to evaluate the relationships between nutritional–inflammatory indices—C-reactive protein–Albumin–Lymphocyte (CALLY) index, Prognostic Nutritional Index (PNI), Controlling Nutritional Status (CONUT) score, and Geriatric Nutritional Risk Index (GNRI)—and disease activity in patients with RA. Materials and Methods: Clinical and laboratory data of 199 RA patients who presented to the Rheumatology Outpatient Clinic between January 2024 and July 2025 were retrospectively analyzed. Disease activity was assessed using DAS28-CRP, CDAI, and SDAI scores. PNI, CONUT, CALLY, and GNRI values (for patients aged ≥60 years) were calculated, and their correlations with disease activity and nutritional parameters were examined. Results: The study included 199 patients with a mean age of 53.4 ± 14.5 years, of whom 72.9% were female. The CALLY and PNI indices showed strong negative correlations with disease activity indicators, including DAS28-CRP and SDAI scores. The CONUT score was not significantly associated with disease activity. In the geriatric subgroup (≥60 years), correlations between all indices and disease activity were stronger, and GNRI was found to be negatively associated with both malnutrition risk and inflammatory activity. Conclusion: The CALLY and PNI indices are reliable and practical laboratory markers that comprehensively reflect inflammatory burden and nutritional status in RA. GNRI appears clinically useful for assessing malnutrition and inflammation-related frailty, particularly in older patients. Integrating nutritional–inflammatory indices into routine clinical evaluation may enhance comprehensive monitoring of disease activity and support comprehensive patient management.
Keywords : CRP-albümin-lenfosit (CALLY), romatoid artrit, hastalık aktivitesi, geriatrik nutrisyonel risk indeksi (GNRI)

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