Impact of zonulin on the depressive and anxious states in patients with ulcerative colitis

Abstract

Aim: The objective of this study is to investigate serum zonulin levels in patients diagnosed with ulcerative colitis and to examine the association between serum zonulin concentrations and the Beck Depression and Anxiety Inventory scores. Symptoms of depression and anxiety in patients with inflammatory bowel disease (IBD) are believed to be associated with increased intestinal permeability. Zonulin, a protein that modulates tight junctions between cells of the intestinal wall, has been studied as a marker of intestinal barrier integrity. Materials and Methods: This study was designed as a prospective investigation, conducted among patients with ulcerative colitis (UC) who were in clinical remission, as determined by both clinical assessments and laboratory tests, between November and December 2017. Demographic and clinical data were collected. All consecutive patients were evaluated using the Beck Depression and Anxiety Inventories. Serum zonulin levels were measured in each patient. Results: The mean age of the 50 patients was 47.3±12.2 years. The mean disease duration of these patients was 7.2±5.9 years. Mild depression was observed in 10 patients (20%), while moderate depression was present in 3 patients (6%). Similarly, mild anxiety affected 8 patients (16%), and moderate anxiety was noted in 6 patients (12%). Serum zonulin levels were significantly higher in obese patients compared to those with normal or overweight body mass indices (p<0.001). Serum zonulin levels showed a moderate positive correlation with body mass index (r=0.586, p<0.001), Beck Depression Inventory scores (r=0.508, p<0.001), and Anxiety Inventory scores (r=0.437, p=0.002). Conclusion: Obesity was significantly associated with elevated serum zonulin levels. In addition, depression and anxiety scores were moderately correlated with serum zonulin levels in patients with ulcerative colitis.