Abstract
Objectives The aims of this study were to evaluate the C-reactive protein/albumin ratio (CRP/ALB), inflammatory markers, and parameters from the complete blood count (CBC) in patients with inflammatory bowel disease (IBD) and their associations with disease activity. Methods A total of 876 IBD patients, composed of 275 patients with ulcerative colitis (UC) and 601 patients with Crohn's disease (CD), were included in this retrospective study, and the serum C-reactive protein (CRP), albumin (ALB), erythrocyte sedimentation rate (ESR), and CBC parameters were measured. To explore the disease activity, the Mayo score and Crohn disease activity index were used to assess UC and CD patients, respectively. Results The CRP/ALB ratio, CRP, ESR, platelet to lymphocyte ratio (PLR), red blood cell distribution width (RDW), and neutrophil to lymphocyte ratio (NLR) levels in active IBD patients were significantly higher than those in inactive IBD patients, whereas ALB and lymphocyte to monocyte ratio (LMR) levels were significantly decreased (P < 0.001). The receiver operating characteristic analysis showed that the optimum cut-off values of the CRP/ALB ratio for active UC and CD were 0.18 and 0.43, with sensitivities of 67.8% and 75.8% and specificities of 86.7% and 92.0%, respectively. Multivariable logistic analysis revealed that after adjusting for these inflammatory markers (ESR, NLR, PLR, and LMR), the CRP/ALB ratio was a statistically significant parameter capable of differentiating the disease activity of UC and CD. Conclusions This study indicated that the CRP/ALB ratio was closely related to the IBD disease activity. Compared with CBC parameters, the CRP/ALB ratio had a higher discriminative capacity for active IBD.
Highlights
Inflammatory bowel disease (IBD), a life-long disease resulting from the interaction of environmental and genetic elements, has been a global healthcare problem with a steadily increasing incidence [1]
Multivariate logistic regression for the C-reactive protein/albumin ratio (CRP/ALB) ratio, erythrocyte sedimentation rate (ESR), neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and lymphocyte to monocyte ratio (LMR) was carried out to reveal which biomarkers were significantly associated with the disease activity in ulcerative colitis (UC) and Crohn’s disease (CD) patients
The total 876 IBD patients included in the study consisted of 275 UC patients and 601 CD patients
Summary
Inflammatory bowel disease (IBD), a life-long disease resulting from the interaction of environmental and genetic elements, has been a global healthcare problem with a steadily increasing incidence [1]. IBD is mainly composed of two different bowel-relapsing disorders, including Crohn’s disease (CD) and ulcerative colitis (UC). Detection of the disease activity of IBD is of great significance for the treatment of this disease, which can effectively prevent complications and improve prognosis as well as quality of life [2, 3]. Biomarkers of IBD can provide helpful information regarding the disease activity. Despite many efforts in the discovery of new biomarkers [4,5,6,7], endoscopy continues to be the gold standard for the diagnosis and evaluation of the disease activity in IBD patients. Further studies are needed to find a cost-effective and noninvasive biomarker for clinical practice
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