BackgroundFaecal calprotectin (FCal) levels are used as a surrogate marker for mucosal inflammation, but thresholds for defining endoscopic or histological disease activity in ulcerative colitis UC) remain unclear. MethodsUsing validated indices, prospective measurements of FCal, symptoms (Simple Colitis Clinical Activity Index, SCCAI), endoscopic (Ulcerative Colitis Endoscopic Index of Severity, UCEIS) and histological activity (Nancy index) were made over 6 months in patients enrolled into the TrueColours UC web-based monitoring programme. Repeated measurements correlation was performed between FCal and SCCAI, UCEIS and Nancy indices using definitions for remission and active disease (UCEIS: remission1, active4; Nancy: remission1, active2; Combined criteria: remission UCEIS1 and Nancy1, active UCEIS4 and Nancy2). Receiver operating characteristic curves investigated FCal thresholds after maximising sensitivity for active disease. ResultsIn 39 patients followed prospectively for 6 months, correlation coefficients between FCal and SCCAI, UCEIS and Nancy indices were 0.271 (95% CI 0.114-0.415), 0.741 (95% CI 0.289-0.922) and 0.876 (95% CI 0.605-0.965) respectively. Median FCal thresholds for remission using endoscopic, histologic, or combined criteria were 71g/g (range 8-624), 91g/g (range 8-858) and 67g/g (range 8-479), respectively. The FCal threshold above which active disease was confirmed was 187g/g for UCEIS (AUC 0.915), 72g/g for Nancy (AUC 0.824) and 187g/g for combined endoscopic and histologic criteria (AUC 0.936). ConclusionsCorrelation between FCal and symptoms in UC is weak. In contrast, the correlation between FCal and endoscopic or histological activity is strong. An FCal 72g/g indicates histological inflammation (Nancy 2) and 187g/g indicates endoscopically active disease (UCEIS  4), whether combined with histopathology or not. *Values presented as median (range), UCEIS: remission  1, active 4; Nancy: remission  1, active 2; Combined criteria: remission UCEIS  1 and Nancy  1, active UCEIS 4 and Nancy 2.Values are presented as median (95% CI). FCal = IBDoc  faecal calprotectin (measured in g/g of faeces) PPV = positive predictive value, NPV = negative predictive value, LR+ = positive diagnostic likelihood ratio, LR-= negative diagnostic likelihood ratio, AUC = area under curve

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Background: Mid-life hypertension is an established risk factor for cognitive impairment and dementia and related to greater brain atrophy and poorer cognitive performance. Previous studies often have small sample sizes from older populations that lack utilizing multiple measures to define hypertension such as blood pressure, self-report information, and medication use; furthermore, the impact of the duration of hypertension is less extensively studied. Objective: To investigate the relationship between hypertension defined using multiple measures and length of hypertension with brain measure and cognition. Methods: Using participants from the UK Biobank MRI visit with blood pressure measurements (n = 31,513), we examined the cross-sectional relationships between hypertension and duration of hypertension with brain volumes and cognitive tests using generalized linear models adjusted for confounding. Results: Compared with normotensives, hypertensive participants had smaller brain volumes, larger white matter hyperintensities (WMH), and poorer performance on cognitive tests. For total brain, total grey, and hippocampal volumes, those with greatest duration of hypertension had the smallest brain volumes and the largest WMH, ventricular cerebrospinal fluid volumes. For other subcortical and white matter microstructural regions, there was no clear relationship. There were no significant associations between duration of hypertension and cognitive tests. Conclusion: Our results show hypertension is associated with poorer brain and cognitive health however, the impact of duration since diagnosis warrants further investigation. This work adds further insights by using multiple measures defining hypertension and analysis on duration of hypertension which is a substantial advance on prior analyses—particularly those in UK Biobank which present otherwise similar analyses on smaller subsets.