Abstract
OBJECTIVES:Anemia and changes in platelets (PLT) are common in inflammatory bowel disease (IBD). In our study, we aimed to verify whether PLT count can independently reflect the severity of IBD.METHODS:In our hospital, 137 Crohn’s Disease (CD), 69 Ulcerative colitis (UC) patients, and 412 healthy controls were included to compare the differences in PLT count. In addition, the effect of anemia, C-reactive protein (CRP), age, CD activity index (CDAI) or Mayo on PLTs was also analyzed. If PLTs independently affected CD or UC, we used the receiver operating characteristic (ROC) curve to verify the diagnostic value and obtain the cut-off value of PLT.RESULTS:CD and UC patients had higher PLT than controls (p<0.001, p<0.001; respectively). In CD patients, the results showed that patients with anemia (P<0.01), Iron Deficiency Anemia (IDA) (p<0.001), CRP≥8 mg/L (p=0.046), and CDAI≥150 (p<0.001) had higher PLT, while in UC patients, those with anemia (p=0.018), CRP≥8 mg/L (p=0.045), and Mayo≥3 (p=0.029) had higher PLT. Univariate analysis showed that CDAI was positively correlated with PLT count (p<0.001), while hemoglobin (p=0.001) and age (p<0.001) were negatively correlated with PLT in CD. In UC patients, Mayo (p=0.001) and CRP (p<0.001) were positively correlated with PLT, while hemoglobin (p=0.002) was negatively correlated. Finally, by linear stepwise multivariate analysis, we clarified the positive relationship between PLT and CD (p<0.001) by eliminating the interference of hemoglobin, and determined the cut-off value of PLT as 298×109/L. For UC, we did not obtain similar results.CONCLUSIONS:PLT can be an indicator of disease severity in CD, while there is a lack of evidence regarding this finding in UC.
Highlights
Inflammatory bowel disease (IBD), including Crohn’s disease (CD) and ulcerative colitis (UC), refers to a group of chronic gastrointestinal disorders characterized by dysregulated intestinal inflammation [1]
We found that CD and UC patients had higher PLT than the controls (294.58±103.86 vs. 208.97±50.39, po0.001; 267.29±109.34 vs. 209.68±59.2, po0.001; respectively) (Figure 1 A and B)
In UC patients, we found that Mayo (p=0.001, Beta=0.391; Figure 5A) and C-reactive protein (CRP) were positively correlated with PLT, while hemoglobin (p=0.002, Beta=-0.374; Figure 5C) was negatively correlated with PLT
Summary
Inflammatory bowel disease (IBD), including Crohn’s disease (CD) and ulcerative colitis (UC), refers to a group of chronic gastrointestinal disorders characterized by dysregulated intestinal inflammation [1]. The immune dysregulation may dominate IBD pathogenesis with its active components [2], while other factors such as genetic [3] and environmental factors [4] have been implicated. An increasing amount of evidence has highlighted the importance of non-immune cells and platelets (PLT) as key players in the development of IBD [5]. The primary role of PLT is hemostasis, including surveying the endothelial barrier consistency and interfering when vessel. Received for publication on October 24, 2019. Accepted for publication on March 26, 2020
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