# Inflammatory Indices as Markers of Vascular and Organ Involvement in Behçet’s Disease

## TL;DR

This study explores how inflammatory markers relate to disease severity and outcomes in Behçet’s disease, finding they help identify vascular and organ involvement but not mortality.

## Contribution

The study introduces CRP-based composite inflammatory indices (IBI-NLR and IBI-SII) to better assess systemic inflammation in Behçet’s disease.

## Key findings

- Inflammatory indices like IBI-NLR and IBI-SII show modest discrimination for vascular and major organ involvement in Behçet’s disease.
- Mortality in Behçet’s disease is linked to higher creatinine, elevated ESR, and lower uric acid levels, not inflammatory indices.
- Male sex and elevated ESR are associated with more severe disease manifestations in Behçet’s disease.

## Abstract

Background: Behçet’s disease is a multisystem inflammatory disorder with a variable clinical course. This study evaluated the association between inflammatory indices, clinical involvement, and mortality. Methods: This retrospective study included 444 patients with BD. Clinical characteristics and laboratory data were systematically retrieved from electronic medical record system. Inflammatory indices (NLR, PLR, SII) were calculated to reflect systemic inflammation. In addition, CRP-based composite indices (IBI-NLR and IBI-SII) were derived to integrate cellular and acute-phase inflammatory responses. Disease manifestations, major organ involvement, comorbidities, and mortality were recorded to comprehensively assess disease burden and clinical outcomes. Results: In multivariable analysis, vascular involvement was associated with increased ESR level (OR = 1.013, 95% CI: 1.002–1.024, p = 0.018), and male sex (OR = 3.22, 95% CI: 1.83–5.67, p < 0.001;). ROC analysis showed the highest discriminatory performance for vascular involvement, with IBI-NLR (AUC = 0.624, p < 0.001), IBI-SII (AUC = 0.609, p = 0.001) and NLR (AUC = 0.597, p = 0.004). Moreover, NLR (AUC = 0.571, p = 0.017), IBI-NLR (AUC = 0.576, p = 0.010), and IBI-SII (AUC = 0.562, p = 0.036) had modest discrimination for major organ involvement. In contrast, inflammatory indexes were not predictive for mortality (p > 0.05 for all). Mortality was independently associated with higher creatinine (OR = 1.086, p = 0.048), higher ESR (OR = 1.023, p = 0.046), and lower uric acid levels (OR = 0.454, p = 0.002). Conclusions: Inflammatory indices may not predict mortality in BD but can help identify vascular and major organ involvement. Male sex and ESR level are associated more severe disease, while mortality is associated with renal dysfunction and systemic inflammation in BD.