IDDF2019-ABS-0186 Correlation between serological biomarkers and disease activity in patients with inflammatory bowel disease. (June 2019) - Xu, Mengque
Abstract : Background: Current biomarkers have been routinely non-invasive methods for assessing disease activity of inflammatory bowel disease (IBD), but none of them are specific. This study was aimed to determine the performance of the serological biomarkers for detecting disease activity in patients with IBD. Methods: A prospective study that included 73 ulcerative disease (UC) subjects, 141 Crohn's disease (CD) subjects, and 30 of them were complicated with C. difficile infection (CDI), randomly selected from a single-institution IBD database. Disease activity was assessed using by Truelove and Witts criteria for UC and Harvey Bradshaw Simple Index for CD. Serological inflammatory biomarkers were compared in different severity groups. Receiver operator curve analyses assessed the performance of each biomarker in discriminating disease states. Results: For UC patients, elevated monocyte counts, C reactive protein (CRP) and decreased lymphocyte counts, lymphocyte/monocyte ratio (LMR) significantly differed between subjects with active UC and UC in remission, and LMR performed better than the other leukocyte profiles. LMR of 3.1 was 76% sensitive and had a specificity of 67% for active UC (figure 1 ). CRP and fibrinogen were significantly elevated in UC with CDI compared to inactive UC without CDI patients. For CD patients, higher values of white blood cells, neutrophils, monocytes, neutrophil/lymphocyte ratio, CRP fibrinogen, and lowe values of LMR and hemoglobin were significantly different between subjects with active CD and CD in remission. None of the biomarkers included had a good correlation with disease activity (Area Under the ROC curve [AUC] < 0.70) (figure 2 ). CD with CDI patients compared with CD patients in remission showed significantly higher CRP. Conclusions: A low LMR represents an inexpensive, readily available test with a promising value to identify disease activity in UC patients. Whereas none of the inflammatory biomarkers showed a discriminative value in disease activity of CD.