Predictive values of stool-based tests for mucosal healing among Taiwanese patients with ulcerative colitis: a retrospective cohort analysis

Yen, Hsu‐Heng; Chen, Mei-Wen; Chang, Yen-Hwa; Huang, Hsuan-Yuan; Hsu, Tsui-Chun; Chen, Yang‐Yuan

doi:10.7717/peerj.9537

Cited by 11 publications

(12 citation statements)

References 26 publications

(64 reference statements)

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“…Food and medication, as well as blood from dietary sources or upper GI bleeding, can result in a positive test[ 20 ]. When compared to FC in a retrospective analysis in UC patients, iFOBT showed higher sensitivity and specificity for assessing MH (80.6% and 100% vs 74.1% and 84.2%, respectively)[ 21 ].…”

Section: Resultsmentioning

confidence: 99%

Surrogate markers of mucosal healing in inflammatory bowel disease: A systematic review

State¹,

Negreanu²,

Voiosu³

et al. 2021

WJG

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BACKGROUND Mucosal healing (MH) has emerged as a key therapeutic target in inflammatory bowel disease (IBD), and achievement of this goal is documented by endoscopy with biopsy. However, colonoscopy is burdensome and invasive, and substitution with an accurate noninvasive biomarker is desirable. AIM To summarize published data regarding the performance of noninvasive biomarkers in assessing MH in IBD patients. METHODS We conducted a systematic review of studies that reported the performance of biomarkers in diagnosing MH in patients with IBD. The main outcome measure was to review the diagnostic accuracy of serum and fecal markers that showed promising utility in assessing MH. RESULTS We screened 1301 articles, retrieved 46 manuscripts and included 23 articles for full-text analysis. The majority of the included manuscripts referred to fecal markers (12/23), followed by circulatory markers (8/23); only 3/23 of the included manuscripts investigated combined markers (serum and/or fecal markers). Fecal calprotectin (FC) was the most investigated fecal marker for assessing MH. In ulcerative colitis, for cutoff levels ranging between 58 mcg/g and 490 mcg/g, the sensitivity was 89.7%-100% and the specificity was 62%-93.3%. For Crohn’s disease, the cutoff levels of FC ranged from 71 mcg/g to 918 mcg/g (sensitivity 50%-95.9% and specificity 52.3%-100%). The best performance for a serum marker was observed for the endoscopic healing index, which showed a comparable accuracy to the measurement of FC and a higher accuracy than the measurement of serum C-reactive protein. CONCLUSION Several promising biomarkers of MH are emerging but cannot yet substitute for endoscopy with biopsy due to issues with reproducibility and standardization.

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Section: Resultsmentioning

confidence: 99%

Surrogate markers of mucosal healing in inflammatory bowel disease: A systematic review

State¹,

Negreanu²,

Voiosu³

et al. 2021

WJG

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“…The prevalence of NAFLD has seen a rapid increase in the Asian population in the past decade [ 7 , 25 ], with the highest prevalence in Iran (64.29%) and the lowest in Taiwan (30.79%) [ 7 ]. During the same period, the incidence of IBD has increased worldwide, particularly in the Asia-Pacific region [ 1 , 2 ]. Our recent national cohort study in Taiwan reported a six-fold increase in the prevalence of IBD over the past 15 years.…”

Section: Discussionmentioning

confidence: 99%

“…Inflammatory bowel disease (IBD, including ulcerative colitis [UC] and Crohn's disease [CD]) is a chronic inflammatory disease affecting the gastrointestinal tract that has seen increased incidence and prevalence in Asia in the 21st century [1][2][3][4]. Non-alcoholic fatty liver disease (NAFLD) is becoming the most common chronic liver disease in the world, surpassing chronic hepatitis B [5] and hepatitis C [6] and affecting 22.28%-51.04% of the Asian population [7].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of non-alcoholic fatty liver disease in patients with inflammatory bowel disease using controlled attenuation parameter technology: A Taiwanese retrospective cohort study

Yen

Huang

et al. 2021

PLoS ONE

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Background/purpose An increased prevalence of non-alcoholic fatty liver disease (NAFLD) is observed in patients with inflammatory bowel disease (IBD) in Western countries. Both intestinal inflammation and metabolic factors contribute to the pathogenesis of IBD-associated NAFLD. The burden of NAFLD is not clear in the Asian population. This study aimed to evaluate the prevalence of NAFLD and liver fibrosis in a cohort of Taiwanese patients with IBD. Methods From January to December 2019, patients with IBD who underwent ultrasound examination were enrolled. Hepatic steatosis and fibrosis were measured with liver stiffness measurement (LSM) and controlled attenuation parameter (CAP) using FibroScan. Patients with a history of excessive alcohol or recent steroid use were excluded. Univariate and multivariate analysis were performed. Results A total of 81 consecutive patients were enrolled and included in the analysis (45 with ulcerative colitis, 36 with Crohn’s disease). The median age was 42 years old. The patients were classified in terms of body mass index as normal weight (54.3%), underweight (11.1%), overweight (28.4%), and obese (6.2%). The mean CAP increased to 162.22 dB/m in the underweight group, 210.86 dB/m in the normal weight group, 260.7 dB/m in the overweight group, and 274.0 dB/m in the obese group. NAFLD was observed in 29.6% of the patients, 1.2% of which had significant fibrosis. Increased body mass index (odds ratio [OR] 1.33, 95% confidence interval [CI] 1.1–1.62) and older age at IBD diagnosis (OR: 1.05, 95% CI 1–1.11) was found to be associated with the presence of NAFLD. Conclusion In this study, the prevalence of NAFLD was lower (29.6%) in IBD patients than in the Western population. Higher BMI and older age were associated with NAFLD in our study.

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“…From January 2019, patients diagnosed with IBD, including UC or CD, received care in the hospital from a dedicated IBD nurse (TSH), who helped in reviewing patients’ clinical history and symptom, educating patients about the disease, and assessing the effects and/or side effects of treatment during each outpatient clinic visit. [ 12 ] The data in this analysis were reviewed by TSH and HHY. This study was approved by the institutional review board of Changhua Christian Hospital (approval number: CCH IRB 190814).…”

Section: Methodsmentioning

confidence: 99%

Clinical features and treatment of inflammatory bowel disease in a low-incidence area

et al. 2021

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Inflammatory bowel disease (IBD) has emerged in the Asia–Pacific area over the past 2 decades. There is a paucity of clinical data regarding real-world experience of patients with IBD from low endemic area such as Taiwan. Therefore, the present study aimed to review the clinical features of patients with IBD form a tertiary center from Taiwan. A total of 163 patients with IBD were identified from the electronic clinical database of Changhua Christian Hospital. Demographic data of the patients and clinical features of the disease pattern were retrospectively reviewed. There was a higher proportion (62.6%) of patients diagnosed with ulcerative colitis (UC). Patients with Crohn disease (CD) and UC had male predominance. The median age of diagnosis was younger in patients with CD than in patients with UC (CD vs UC: 31 vs 40 years, P = .0423). The disease distribution of UC was as follows: E1 (15.7%), E2 (47.1%), and E3 (37.3%). The disease distribution of CD was as follows: L1 (36.1%), L2 (14.8%), L3 (42.6%), and L4 (6.5%). The majority of patients with CD had a complicated presentation with B2 (32.8%) and B3 (32.8%). Patients with CD had a higher bowel resection rate than patients with UC. Patients with CD were more likely to be treated with immunomodulator and biologics and those with UC were more likely to be treated with 5-aminosalicylic acid (5-ASA). A trend of decreased bowel resection for patients with IBD and less severe phenotype of patients with CD were observed after 2015. UC with male predominance was the predominant type of IBD in the study. Patients with CD are likely to have a complicated disease course, requiring a higher demand of biologic therapy than patients with UC.

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Predictive values of stool-based tests for mucosal healing among Taiwanese patients with ulcerative colitis: a retrospective cohort analysis

Cited by 11 publications

References 26 publications

Surrogate markers of mucosal healing in inflammatory bowel disease: A systematic review

Surrogate markers of mucosal healing in inflammatory bowel disease: A systematic review

Evaluation of non-alcoholic fatty liver disease in patients with inflammatory bowel disease using controlled attenuation parameter technology: A Taiwanese retrospective cohort study

Clinical features and treatment of inflammatory bowel disease in a low-incidence area

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