Factors associated with poor compliance amongst hospitalized,predominantly adolescent pediatric Crohn’s disease patients

BackgroundCompliance with medical treatment is vital for the control of inflammatory bowel disease (IBD) and prevention of disease complications and is an issue in paediatric patients. We explored patient-related factors associated with non-compliance in a large database of predominantly adolescent, hospitalized paediatric Crohn’s disease (CD) patients.Patients/Materials and MethodsWe analyzed data from the Kid’s Inpatient Database (KID) the largest publicly available all-payer paediatric inpatient care database in the United States. All available paediatric CD patients non-electively admitted in 2016 were included. CD patients were extracted using the standard international classification of diseases (ICD) 10 codes. Data suggesting non-compliance, comorbidities and surgical procedures related to CD were similarly extracted.Results2439 paediatric CD patients with non-elective admission were included in the analysis. 2 280 patients (94%) were adolescents. Of the total cohort, 113 patients (4.6%) had a diagnosis of non-compliance. In univariate analyses, smoking (15.9 vs. 5.5%, p < .001), cannabis use (5.3 vs 1.5%, p = .009), and a diagnosis of depression (19.5 vs. 9%, p = .001) or schizoaffective disorder (5.3 vs 0.3%, p < .001) were associated with non-compliance. Multivariable analysis revealed that schizoaffective disorder (odds ratio (OR) 11.6, 95% CI 3.6–37.2), depression (OR 1.9, 95%CI 1.2-3.2) and smoking (OR 2.2, 95%CI 1.25–4) were independently associated with non-compliance.ConclusionsIn this study, mental health disorders and smoking were independently associated with non-compliance to medication in predominantly adolescent, hospitalized paediatric CD patients. A multidisciplinary approach involving paediatric gastroenterologists, psychiatrists and addiction specialists are needed to treat the underlying causes and improve adherence in these patients.

KEY MESSAGES

• Mental health disorders and smoking are independent risk factors for medication non-compliance amongst adolescent, paediatric CD patients.
• A multidisciplinary approach is required to treat underlying causes and improve adherence in paediatric IBD patients.

     

Pediatric case of Crohn’s disease with preceding vulvitis granulomatosa

Crohn’s disease (CD) of the vulva is a rare and under‐recognized condition. Since vulvar lesions may precede the diagnosis of digestive CD in approximately 25% of all cases, the coexistence or future onset of CD should be considered regardless of the gastrointestinal symptoms, even for pediatric patients.     

Low serum interleukin‐38 levels in patients with Graves’ disease and Hashimoto’s thyroiditis

BackgroundAutoimmune thyroid disease (AITD) mainly includes Graves’ disease (GD) and Hashimoto''s thyroiditis (HT), which is caused by individual genetics, autoimmune dysfunction, and a variety of external environmental factors. Interleukin (IL)‐38 is involved in a wide range of autoimmune diseases, but little is known about IL‐38 expression in AITD.MethodsFifty patients with GD, 50 with HT, and 50 healthy controls (HC) were enrolled in this study. Basic information of the participants was obtained through a physical examination. Immunological data were obtained by an automatic chemiluminescence immunoanalyzer. C‐reactive protein (CRP) concentrations and the white blood cell count were measured. Serum IL‐38 levels were determined by an enzyme‐linked immunosorbent assay.ResultsSerum IL‐38 levels were significantly lower in the GD and HT groups than in the HC group (both p < 0.01). Serum CRP concentrations were significantly lower in the HT group than in the HC group (p < 0.05). Receiver operating characteristic curve analysis showed that the area under the curve was 0.7736 (p < 0.01) for IL‐38 and 0.7972 (p < 0.01) for IL‐38 combined with CRP in the GD group. In the HT group, the area under the curve was 0.7276 (p < 0.01) for IL‐38 and 0.7300 for IL‐38 combined with CRP (p < 0.01).ConclusionsThe results suggest that serum IL‐38 level is a potential new diagnostic biomarker in patients with GD and HT.     

Perforating and nonperforating indications in repeated surgeries for Crohn’s disease

BACKGROUNDDespite advances in medical therapy for Crohn’s disease (CD), most patients with CD require repeated resection surgeries. AIMTo analyze the perforating and nonperforating indications of repeated CD operations and identify the anastomosis characteristics for postoperative CD.METHODSWe retrospectively reviewed 386 patients who underwent at least one resection for CD between 2003 and 2013.Clinical characteristics of each surgery were collected. Univariate and multivariate analyses were performed to determine risk factors for recurrence.RESULTSThe indication for reoperation in CD tends to be the same as that for primary operation, i.e., perforating disease tends to represent as perforating disease and nonperforating as nonperforating. Concordance was found between the first surgery and second surgery in terms of the indication for the operation (P = 0.006), and the indication for the third surgery was also correlated with that for the second surgery (P = 0.033). Even if the correlation of surgical indications between repeated operations, the rate of perforating indication for the second and third surgeries was significantly higher than that of the first surgery. In addition, the presence of perforating CD was a predictor of recurrence for both the first and second surgeries. Moreover, anastomotic lesions were the most common sites of recurrence after the operation. Based on the importance of anastomosis, anastomosis might be a new type of disease location for the classification of postoperative CD.CONCLUSIONCD not only has stable characteristics but also progresses chronically. Perforation is a progressive surgical indication for Crohn’s disease. For CD after surgery, anastomosis may be a new classification of disease location.     

Biologic therapy for Crohn’s disease over the last 3 decades

BACKGROUNDDespite the overload of publications on Crohn’s disease (CD), no comprehensive analysis of biologic therapy for CD has been reported.AIMTo determine knowledge gaps and identify areas of interest of biologic therapy for CD.METHODSThe top 100 highest-cited original articles were identified from January 1991 to December 2020 in the Clarivate Analytics Web of Science Core Collection database. We conducted a bibliometric analysis of biologic therapy for CD based on total citations, summarized the bibliographic information of the articles related to CD biologic therapy, and explored the research hotspots.RESULTSThe top 100 highest-cited original articles were identified with total citations ranging from 307 to 2978. The 2000s (Period II, n = 66) yielded the most influential original articles and saw the most dramatic growth. Among the top 10 countries, including 8 European countries and 2 North American countries, the United States (n = 37) and Belgium (n = 20) contributed the most publications. Among the top 10 institutions, the University Hospital Gasthuisberg in Belgium (n = 23), the University of Chicago in the United States (n = 20), and the Mayo Clinic in the United States (n = 17) published the most papers. Regarding authors, Rutgeerts P in Belgium (n = 32), Sandborn WJ in the United States (n = 23), and Feagan BG in Canada (n = 18) published the highest number of studies. The cooperation relationships between the United States and Europe were most frequent. Gastroenterology (impact factor = 22.682) published the most articles on biologic therapy for CD (n = 32) with 17654 total citations. Anti-tumor necrosis factor biologics and monoclonal antibodies were the most studied topics.CONCLUSIONThe bibliometric analysis emphasized the key contributions to the development of the specialized field. These data would provide useful research insights into biologic therapy for CD for clinicians and researchers.     

Comparison of mucosa-associated microbiota in Crohn’s disease patients with and without anti-tumor necrosis factor-α therapy

Most studies on the gut microbiome of Crohn’s disease have been conducted using feces, instead of intestinal mucus to analyze the mucosa-associated microbiota. To investigate the characteristics of mucosa-associated microbiota in Crohn’s disease patients and the effect of anti-tumor necrosis factor (TNF)-α therapy on mucosa-associated microbiota, we analyzed microbiota in Crohn’s disease patients using brushing samples taken from terminal ileum. The recruited subjects were 18 Crohn’s disease patients and 13 controls. There were 10 patients with anti-TNF-α therapy in Crohn’s disease group. Crohn’s disease patients had significantly reduced α-diversity in Shannon index compared to the controls. The comparative analysis of the taxonomic composition at the genus level between the Crohn’s disease group and the controls indicated that butyrate-producing bacteria were less abundant in the Crohn’s disease group compared to the controls. There were no differences in the diversity between the patients taking anti-TNF-α therapy and the patients without. The comparative analysis of the taxonomic composition at the genus level between the two groups indicated that some of anti-inflammatory bacteria were less abundant in the anti-TNF-α therapy group than the other. Reduction of specific bacteria producing anti-inflammatory molecules, especially butyrate-producing bacteria may play important roles in the pathophysiology of Crohn’s disease.     

Postoperative diarrhea in Crohn’s disease: Pathogenesis,diagnosis, and therapy

Diarrhea is a frequent symptom in postoperative patients with Crohn’s diseases (CD), and several different mechanisms likely account for postoperative diarrhea in CD. A targeted strategy based on a comprehensive understanding of postoperative diarrhea is helpful for better postoperative recovery.     

Lysophosphatidylserines derived from microbiota in Crohn’s disease elicit pathological Th1 response

Microbiota alteration and IFN-γ–producing CD4⁺ T cell overactivation are implicated in Crohn’s disease (CD) pathogenesis. However, it remains unclear how dysbiosis enhances Th1 responses, leading to intestinal inflammation. Here, we identified key metabolites derived from dysbiotic microbiota that induce enhanced Th1 responses and exaggerate colitis in mouse models. Patients with CD showed elevated lysophosphatidylserine (LysoPS) concentration in their feces, accompanied by a higher relative abundance of microbiota possessing a gene encoding the phospholipid-hydrolyzing enzyme phospholipase A. LysoPS induced metabolic reprogramming, thereby eliciting aberrant effector responses in both human and mouse IFN-γ–producing CD4⁺ T cells. Administration of LysoPS into two mouse colitis models promoted large intestinal inflammation. LysoPS-induced aggravation of colitis was impaired in mice lacking P2ry10 and P2ry10b, and their CD4⁺ T cells were hyporesponsive to LysoPS. Thus, our findings elaborate on the mechanism by which metabolites elevated in patients with CD harboring dysbiotic microbiota promote Th1-mediated intestinal pathology.     

Association between ABO blood group and risk of Crohn’s disease: A case‐control study in the Chinese Han population

BackgroundBlood group O has been reported to be a potentially protective factor for Crohn''s disease (CD) susceptibility in Caucasian and Korean populations, but a similar conclusion was not found in a Chinese study. The present study investigated the potential association in the Chinese Han population.MethodsWe included 275 CD patients, 132 ulcerative colitis (UC) patients and 1201 healthy individuals in this case‐control study. The demographic characteristics and ABO blood group were compared among the three groups. The clinical characteristics and treatment of CD were further investigated according to the blood group distribution.ResultsThe blood group distribution in CD patients was significantly different from healthy controls, and the frequency of O blood in CD patients was significantly lower compared to healthy controls. After adjusting for age and gender, the non‐O blood groups remained significantly associated with CD susceptibility in propensity score‐adjusted and propensity score‐matched analyses. Compared to CD patients with non‐O blood groups, patients with O blood were at a lower risk of developing penetrating disease, more likely to receive immunosuppressant treatment and less likely to receive biological treatment.ConclusionOur results confirmed that non‐O blood groups were significantly associated with an increased risk of CD in the Chinese Han population.     

英夫利西单抗组合方案对广泛病变型克罗恩病患者的炎症指标和肠黏膜愈合的影响

目的 观察英夫利西单抗（IFX）组合方案对广泛病变型克罗恩病（CD）患者的炎症指标及肠黏膜愈合的影响。方法 采用中山大学孙逸仙纪念医院的内镜分级评价标准及肠黏膜愈合标准,回顾性分析160例广泛病变型CD患者[IFX组合方案治疗组（98例）、传统药物治疗组（62例）]的炎症指标及肠黏膜愈合资料。结果 IFX组合方案治疗组在第2次治疗前,CRP、ESR、IL-6迅速下降,血清TNF-α升高（P均< 0.05）。IFX组合方案治疗组中,治疗达12次患者的结肠黏膜愈合率与小于12次的患者比较差异有统计学意义（P < 0.05）。IFX组合方案治疗组内镜下总有效率（80.3%,57/71）较传统药物治疗组（64.5%,40/62）患者高（P = 0.041）。结论 应用IFX组合方案可使患者血清TNF-α水平明显升高,但不影响肠黏膜的愈合。IFX组合方案较传统药物治疗组更可促进结肠黏膜愈合。     

Genetic variants associated with metabolic dysfunction‐associated fatty liver disease in western China

IntroductionWe aimed to confirm the association between some single nucleotide polymorphisms (SNPs) and metabolic dysfunction‐associated fatty liver disease (MAFLD) in western China.MethodsA total of 286 cases and 250 healthy controls were enrolled in our study. All samples were genotyped for patatin‐like phospholipase domain containing 3 (PNPLA3) rs738409, transmembrane 6 superfamily member 2 (TM6SF2) rs58542926, membrane‐bound O‐acyltransferase domain containing 7 (MBOAT7) rs641738, glucokinase regulator (GCKR) rs1260326 and rs780094, and GATA zinc finger domain containing 2A (GATAD2A) rs4808199. Using logistic regression analysis, we evaluated the association between MAFLD and each SNP under different models. Multiple linear regression was used to find the association between SNPs and laboratory characteristics. Multifactor dimensionality reduction was applied to test SNP–SNP interactions.ResultsThe recessive model and additive model of PNPLA3 rs738409 variant were related to MAFLD (odds ratio [OR] = 1.791 and 1.377, respectively, p = 0.038 and 0.027, respectively). However, after Benjamini‐Hochberg adjustment for multiple tests, all associations were no longer statistically significant. PNPLA3 rs738409 correlated with AST levels. GCKR rs780094 and rs1260326 negatively correlated with serum glucose but positively correlated with triglycerides in MAFLD. Based on MDR analysis, the best single‐locus and multilocus models for MAFLD risk were rs738409 and six‐locus models, respectively.ConclusionsIn the Han population in western China, no association was found between these SNPs and the risk of MAFLD. PNPLA3 rs738409 was associated with aspartate aminotransferase levels in MAFLD patients. GCKR variants were associated with increased triglyceride levels and reduced serum fasting glucose in patients with MAFLD.     

Associations of HLA genetic variants with carbamazepine‐induced cutaneous adverse drug reactions: An updated meta‐analysis

Aggregated risk of carbamazepine (CBZ)‐induced cutaneous adverse drug reactions (cADRs) with different HLA variants are unclear and limited in terms of the power of studies. This study aimed to assess the aggregated risk of CBZ‐induced cADRs associated with carrying the following HLA variants: HLA‐B*15:02, HLA‐B*15:11, HLA‐B*15:21, HLA‐B*38:02, HLA‐B*40:01, HLA‐B*46:01, HLA‐B*58:01, HLA‐A*24:02, and HLA‐A*31:01. Literature was searched in different databases following PRISMA guidelines. The outcomes were measured as odds ratio (OR) using RevMan software by a random/fixed effects model, where p < 0.05 was set as statistical significance. In total, 46 case–control studies met the inclusion criteria and were included in this analysis consisting of 1817 cases and 6614 controls. It was found that case‐patients who carried the HLA‐B*15:02 allele were associated with a significantly increased risk of CBZ‐induced Stevens−Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) compared to controls (OR 26.01; 95% CI 15.88–42.60; p < 0.00001). The aggregated risk of cADRs was slightly higher in Asian compared to Caucasian patients (Asians: OR 14.84; 95% CI 8.95–24.61; p < 0.00001; Caucasians: OR 11.65; 95% CI 1.68–80.70; p = 0.01). Further, HLA‐B*15:11, HLA‐B*15:21, or HLA‐A*31:01 allele was also associated with significantly increased risk of CBZ‐induced cADRs (HLA‐B*15:11: OR 6.08; 95% CI 2.28–16.23; p = 0.0003; HLA‐B*15:21: OR 5.37; 95% CI 2.02–14.28; p = 0.0008; HLA‐A*31:01: OR 5.92; 95% CI 4.35–8.05; p < 0.00001). Other HLA variants were not found to have any significant associations with CBZ‐induced cADRs. Strong associations between the HLA‐B*15:02, HLA‐B*15:11, HLA‐B*15:21, or HLA‐A*31:01 allele with CBZ‐induced cADRs have been established in this analysis. Pharmacogenetic testing of particular HLA alleles before initiation of CBZ therapy may be beneficial to patients and may help to eradicate cADRs substantially.

Study Highlights WHAT IS THE CURRENT KNOWLEDGE ON THE TOPIC? Studies assessing the aggregated risk of carbamazepine (CBZ)‐induced cutaneous adverse drug reactions (cADRs) associated with carrying HLA genetic variants are conflicting and limited in terms of the power of studies. Besides HLA‐B*1502, HLA‐B*15:11, or HLA‐A*31:01, other potential genetic variants of HLA (e.g., HLA‐B*15:21) were not included in these analyses. Further, the associations of HLA‐A*24:02, HLA‐B*40:01, HLA‐B*46:01, and HLA‐B*58:01 alleles with CBZ‐induced cADRs are controversial. WHAT QUESTION DID THIS STUDY ADDRESS? What is the relationship of some specific HLA genetic variants (e.g., HLA‐B*15:02, HLA‐B*15:11, HLA‐B*15:21, HLA‐B*38:02, HLA‐B*40:01, HLA‐B*46:01, HLA‐B*58:01, HLA‐A*24:02, or HLA‐A*31:01) with cADRs? WHAT DOES THIS STUDY ADD TO OUR KNOWLEDGE? In this meta‐analysis, strong associations between HLA‐B*15:02, HLA‐B*15:11, HLA‐B*15:21, or HLA‐A*31:01 allele with CBZ‐induced cADRs have been established in which the most substantial, robust evidence has been found between HLA‐B*15:02 allele and CBZ‐induced Stevens−Johnson syndrome/toxic epidermal necrolysis (SJS/TEN). Other HLA variants (e.g., HLA‐A*24:02, HLA‐B*40:01, HLA‐B*46:01, and HLA‐B*58:01) were not associated with significantly increased risk of cADRs. HOW MIGHT THIS CHANGE CLINICAL PHARMACOLOGY OR TRANSLATIONAL SCIENCE? Pharmacogenetic testing of particular HLA variants before initiation of carbamazepine therapy may be beneficial to patients and may help to eradicate cADRs substantially. The findings of this analysis may facilitate the rapid translation of some selective HLA variants from bench to bedside.     

Predictors of necessity for endoscopic balloon dilatation in patients with Crohn’s disease-related small bowel stenosis

Background and AimIn patients with Crohn’s disease (CD) and small bowel stenosis, endoscopic balloon dilation (EBD) is considered to be useful in improving stenotic symptoms and avoiding surgery. However, it carries risks such as bleeding and perforation. The aim of this study was to identify the indications for endoscopic intervention in patients with CD and small bowel stenosis.MethodsFrom November 2007 to March 2020, 143 CD patients with small bowel stenosis were enrolled in this study. We identified the factors associated with not requiring endoscopic intervention during long-term follow-up of these patients.ResultsForty of the 143 patients had abdominal symptoms of stenosis and had undergone EBD, whereas the remaining 103 were asymptomatic and had not undergone endoscopic intervention. During long-term follow-up, 95 of those 103 patients never required endoscopic or surgical intervention. Multivariate logistic regression analysis revealed that not consuming an elemental diet (OR 3.18, 95% CI 1.48–6.82; p < .01) and ileocecal valve (ICV) stenosis (OR 0.30, 95% CI 0.11–0.83; p = .02) were independently associated with not requiring EBD. The cumulative emergency hospitalisation-free rate also tended to be higher in patients not consuming an elemental diet or with ICV stenosis.ConclusionsTwo factors, namely not consuming an elemental diet and ICV stenosis, predict a long-term intervention-free prognosis in CD patients with small bowel stenosis.

Key messages

• When an endoscopically impassable small bowel stenosis is found in a CD patient, long-term follow-up without endoscopic intervention may be possible if the patient is asymptomatic, is not using an elemental diet, and the stenosis is ICV.

     

帕金森病患者跌倒预防的最佳证据总结

目的 评价并总结帕金森病患者跌倒预防的相关证据,为临床医护人员预防帕金森病患者跌倒提供借鉴。方法 系统检索国内外相关数据库及帕金森病专业学术网站中关于预防帕金森病患者跌倒的临床决策、指南、证据总结、系统评价、专家共识,检索时限为建库至2021年8月31日,对纳入文献进行方法学质量评价,根据主题对证据进行提取与汇总。结果 共纳入18篇文献,包括2篇临床决策、2篇指南、1篇证据总结、12篇系统评价、1篇专家共识。结合专业人员的判断,从评估与监测、日常安全管理、运动管理、营养支持及教育培训5个方面进行了证据总结,形成24条最佳证据。结论 该研究全面、科学地总结了帕金森病患者跌倒预防的最佳证据,证据使用者在证据转化过程中应考虑具体情境,针对性地选择证据,以便制订符合个体情况的本土化的帕金森病患者跌倒预防管理方案,降低其跌倒发生风险,提升照护质量。     

Venlafaxine‐induced interstitial lung disease with COVID‐19 pandemic‐related depression

Venlafaxine‐associated pulmonary toxicity is rare, with only a few reports of pneumonitis, eosinophilic pneumonia, and asthma. We report a case of venlafaxine‐induced interstitial lung disease in a patient with coronavirus disease 2019 pandemic‐related depression. Chest imaging findings improved after discontinuation of venlafaxine and treatment with corticosteroids.     

Pseudohypoparathyroidism type 1 B mimicking Fahr’s disease in a 28‐year‐old female: A case report

In virtue of precise clinical history, physical examinations, and biochemical/radiological investigations, pseudohypoparathyroidism can be effectively diagnosed, and its types can be differentiated even without exorbitant tests.     

Olfactory identification ability in patients with mild cognitive impairment and Alzheimer’s disease

[Purpose] To examine the olfactory identification abilities and specify the difficult-to-identify odors in community-dwelling individuals with mild cognitive impairment (MCI) and Alzheimer’s disease (AD). [Participants and Methods] We included, 12 and 17 patients with MCI (MCI group) and AD (AD group), respectively, and 30 community-dwelling older adults with no history of MCI or a dementia diagnosis (control group). Scores on the Japanese odor stick identification test (OSIT-J), an olfactory identification ability test, were compared among the three groups with intergroup differences examined accordingly. Next, we performed intergroup comparisons of the ratios of correct responses for each odor, and the difficult-to-identify odors were examined. [Results] OSIT-J scores of the MCI and AD groups were significantly lower than those of the control group. There were no intergroup differences in the correct identification of pungent odors. No patients in the AD group could identify the odor of cooking gas. The ability to identify food-related odors was reduced in the MCI and AD groups. [Conclusion] Patients with MCI and AD had reduced olfactory identification abilities in comparison to community-dwelling older adults without cognitive decline. These findings suggest the importance of olfactory evaluation before providing patients with dementia with therapeutic interventions associated with olfactory stimuli.     

N6-methyladenine-modified DNA was decreased in Alzheimer’s disease patients

BACKGROUNDIn recent years, the prevalence of Alzheimer’s disease (AD) has increased, which places a great burden on society and families and creates considerable challenges for medical services. N6-methyladenine (m6A) deoxyribonucleic acid (DNA) adenine methylation is a novel biomarker and is abundant in the brain, but less common in AD. We support to analyze the relationship between DNA m6A and cognition in patients with AD and normal controls (NCs) in China.AIMTo analyze the relationship between the novel m6A DNA and cognition in patients with AD and NCs in China.METHODSA total of 179 AD patients (mean age 71.60 ± 9.89 years; males: 91; females: 88) and 147 NCs (mean age 69.59 ± 11.22 years; males: 77; females: 70) who were age- and sex-matched were included in our study. All subjects underwent neuropsychological scale assessment and magnetic resonance imaging examination. Apolipoprotein E (APOE) genotypes were measured through agarose gel electrophoresis. Global m6A levels were evaluated by a MethylFlash m6A DNA Methylation ELISA Kit (colorimetric). Global m6A levels in total DNA from ten AD patients with 18F-AV-45 (florbetapir) positron emission tomography (PET) positivity and ten NCs with PET negativity were analyzed by dot blotting to determine the results.RESULTSOur ELISA results showed that the global m6A DNA levels in peripheral blood were different between patients with AD and NCs (P = 0.002; < 0.05). And ten AD patients who were PET positive and ten NCs who were PET negative also showed the same results through dot blotting. There were significant differences between the two groups, which indicated that the leukocyte m6A DNA levels were different (P = 0.005; < 0.05). The m6A level was approximately 8.33% lower in AD patients than in NCs (mean 0.011 ± 0.006 vs 0.012 ± 0.005). A significant correlation was found between the Montreal Cognitive Assessment score and the peripheral blood m6A level in the tested population (r = 0.143, P = 0.01; < 0.05). However, no relationship was found with APOE ε4 (P = 0.633, > 0.05). Further studies should be performed to validate these findings.CONCLUSIONOur results show that reduced global m6A DNA methylation levels are significantly lower in AD patients than in NCs by approximately 8.33% in China.     

C‐reactive protein/albumin ratio and IL‐6 are associated with disease activity in patients with ulcerative colitis

BackgroundCytokines are key mediators of the inflammation in ulcerative colitis (UC); there are inconsistent data on cytokines profile in patients with UC. C‐reactive protein/albumin ratio (CRP/ALB) has also been found as an inflammatory indicator. However, the role of CRP/ALB in UC remains unclear. We aimed to evaluate the CRP/ALB ratio and cytokines profile in patients with UC. We further explore the association between CRP/ALB and inflammatory markers, such as erythrocyte sedimentation rate (ESR), fecal calprotectin (FC) and cytokines.MethodsOne hundred thirty UC patients and 65 controls were included in the study. Clinical and laboratory findings were retrospectively reviewed; differences in variables between two groups were examined using the Mann–Whitney U‐test. The association between CRP/ALB, cytokines, and clinical parameters was determined by Spearman''s correlation test.ResultsCRP/ALB levels were significantly elevated in active UC patients. The optimal cutoff level of the CRP/ALB was 0.083. The patients with active UC had a median interleukin‐6 (IL‐6) level of 7.715 pg/ml (interquartile ranges, IQR 3.475–14.63), which was significantly higher than those in remission (2.95 pg/ml, IQR 2.17–5.44) (p < 0.001). Positive correlations between CRP/ALB and inflammatory markers were also observed.ConclusionsOur results suggest that CRP/ALB and IL‐6 could be potential biomarkers for assessment of clinical activity in Chinese patients with UC.