Serum Globulin Is Associated with Endoscopic Findings and Mucosal Healing in Japanese Patients with Ulcerative Colitis

Shiraishi, Kana; Furukawa, Shinya; Yagi, Sen; Mori, Kenichirou; Nakamura, Tomoyuki; Kawasaki, Keitarou; Mizukami, Yuji; Suzuki, Seiyuu; Uraoka, Masayoshi; Shibata, Naozumi; Nakamura, Sanae; Imamine, Satoshi; Murakami, Hidehiro; Ohashi, Katsuhisa; Torisu, Masamoto; Yano, Makoto; Hasebe, Aki; Yano, Harumi; Murakami, Masato; Takeshita, Eiji; Ikeda, Yoshio; Hiasa, Yoichi

doi:10.1007/s10620-021-06834-5

Cited by 14 publications

(9 citation statements)

References 14 publications

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“…As serological markers might be less sensitive and less specific for intestinal inflammation compared with FC, 27 however, serum albumin should be used as a complementary marker rather than as a substitute for calprotectin. We have previously found associations between platelet, 28 globulin, 7 and bilirubin 8 values and clinical outcomes including MH, though the sensitivity and specificity of these serum markers for clinical outcomes was not sufficiently high to justify using any of them alone. To assess MH using serum markers only, combinations of these markers should be studied in the future.…”

Section: Discussionmentioning

confidence: 96%

“…Novel biomarkers for clinical outcomes have recently been reported including serum globulin, serum indirect bilirubin, neutrophil/lymphocyte ratio, C reactive protein/albumin ratio, albumin/ platelet ratio, and platelet/lymphocyte ratio. [7][8][9][10][11] Now, we may be able to add serum albumin to this list. Serum albumin is known as a marker of acute inflammation.…”

Section: Key Messagesmentioning

confidence: 99%

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Effect of disease duration on the association between serum albumin and mucosal healing in patients with ulcerative colitis

Yagi

Furukawa

Shiraishi

et al. 2021

BMJ Open Gastroenterol

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ObjectiveSerum albumin is used as a marker of acute inflammation. Several studies have addressed the association between serum albumin and clinical outcome in patients with ulcerative colitis (UC). While mucosal healing (MH) has been indicated as the therapeutic goal for UC, the association between serum albumin and MH remains unclear. We evaluated this issue in patients with UC overall and explored whether duration of UC affected this association.DesignThis cross-sectional study recruited consecutive patients with UC. Study subjects consisted of 273 Japanese patients with UC. Serum albumin was divided into tertiles based on its distribution in all study subjects. One endoscopy specialist was responsible for measuring partial MH and MH, which were defined as a Mayo endoscopic subscore of 0–1 and 0, respectively. The association between serum albumin and clinical outcomes was assessed by multivariate logistic regression.ResultsRates of clinical remission, partial MH and MH were 57.9%, 63% and 26%, respectively. Only high serum albumin (>4.4 mg/dL) was significantly positively associated with MH (OR 2.29 (95% CI: 1.03 to 5.29), p for trend=0.043). In patients with short UC duration (<7 years) only, high serum albumin was significantly positively associated with MH and clinical remission. In patients with long UC duration (≥7 years), in contrast, no association between serum albumin and clinical outcomes was found.ConclusionIn Japanese patients with UC, serum albumin was significantly positively associated with MH. In patients with short UC duration, serum albumin might be a useful complementary marker for MH.

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Section: Discussionmentioning

confidence: 96%

Section: Key Messagesmentioning

confidence: 99%

Effect of disease duration on the association between serum albumin and mucosal healing in patients with ulcerative colitis

Yagi

Furukawa

Shiraishi

et al. 2021

BMJ Open Gastroenterol

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“… 14 , 43 In addition, increased serum β2-microglobulin was associated with the activity of IBD. 7 Shiraishi et al 44 found a positive association of endoscopic activity and a negative association of mucosal healing with serum globulin in patients with UC. Serum AGR, as a predictor, was widely applied in the evaluation of malignancies and inflammation.…”

Section: Discussionmentioning

confidence: 99%

Serum Albumin to Globulin Ratio is Associated with the Presence and Severity of Inflammatory Bowel Disease

Wang¹,

Li²,

Wang³

et al. 2022

JIR

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Objective Serum albumin to globulin ratio (AGR) is a marker of inflammatory disease, but its role in inflammatory bowel disease (IBD) remains unknown. The primary purpose of the present research was to explore the relationship between serum AGR and inflammatory bowel disease (IBD). Methods A total of 179 patients with ulcerative colitis (UC), 210 patients with Crohn’s disease (CD), and non-IBD controls (age- and gender-matched controls who have gastrointestinal (GI) symptoms) were enrolled in the research. Demographic data, endoscopic score, and serum biomarkers such as C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), white blood cell (WBC) count, and Ca 2+ were included. The Mayo score and the Harvey-Bradshaw Index (HBI) were applied to evaluate the disease activity of UC and CD, respectively. Results Serum AGR was significantly lower among IBD patients compared with non-IBD controls. There was a negative association between serum AGR and Mayo score in patients with UC (r = −0.413, p < 0.001), and serum AGR was also associated with HBI score in patients with CD (r = −0.471, p < 0.001). After adjusting other potential variables, low serum AGR (below-median) was independently associated with Mayo score ( β = −0.196, p = 0.026) and HBI score ( β = −0.162, p = 0.022), respectively. The area under the curve (AUC) for AGR to distinguish UC was 0.701, and the AUC of CD was 0.759. Based on the optimal cut-off value, multivariate logistic regression indicates that low AGR can differentiate UC from non-UC (OR = 2.564, 95% CI = 1.433–4.587, p = 0.002) and CD from non-CD (OR = 3.732, 95% CI = 1.640–8.492, p = 0.001). Conclusion AGR may become a promising candidate to help clinicians differentiate IBD and evaluate IBD disease activity. Inflammation and nutritional status might be the future directions to explore its mechanism.

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“…The development of an easy, rapid, repeatable, and affordable serum marker for MH is one of the unmet needs related to maintaining MH in the clinical setting. Several novel biomarkers for MH have recently been reported, including the CAR as well as serum globulin, serum indirect bilirubin, neutrophil/lymphocyte ratio, albumin/platelet ratio, and platelet/lymphocyte ratio [ 20 – 23 ]. Our results indicate that CAR should be used as serum marker for disease activity and poor response to treatment but not for MH.…”

Section: Discussionmentioning

confidence: 99%

Effect of disease duration on the association between C-reactive protein-albumin ratio and endoscopic activity in ulcerative colitis

et al. 2022

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Background A simple serum biomarker for clinical outcome in patients with ulcerative colitis (UC) remains an unmet need. Some studies have shown an association between C-reactive protein (CRP)-albumin ratio (CAR) and prognosis in patients with inflammatory bowel disease (IBD), but evidence regarding the association between CAR and UC remains limited. We evaluated the association between CAR and clinical outcome in Japanese patients with UC. Methods Subjects were 273 Japanese patients with UC. Clinical remission was defined as absence of both abnormally high stool frequency (< 3 per day) and rectal bleeding. Mucosal healing (MH) was defined as Mayo endoscopic subscore (MES) 0. Moderate to severe endoscopic activity was defined as MES 2–3. Subjects were divided according to CAR into tertiles (low, moderate, and high). Results The proportions of patients with clinical remission, MH, and moderate to severe endoscopic activity were 57.9%, 26.0%, and 37.0%, respectively. High CAR was significantly positively associated with moderate to severe endoscopic activity but not MH or clinical remission after adjustment (adjusted odds ratio [OR] 2.18 [95% confidence interval (CI) (1.11–4.35)], p for trend 0.023), but only in patients with long disease duration (> 7 years) (adjusted OR 2.95 [95% CI (1.06–8.79)], p for trend 0.023). CAR was not associated with clinical remission or MH. Conclusions CAR may be significantly positively associated with moderate to severe endoscopic activity but not clinical remission or MH in Japanese patients with UC. In patients with long UC duration, CAR might be a useful serum marker for disease activity.

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Serum Globulin Is Associated with Endoscopic Findings and Mucosal Healing in Japanese Patients with Ulcerative Colitis

Cited by 14 publications

References 14 publications

Effect of disease duration on the association between serum albumin and mucosal healing in patients with ulcerative colitis

Effect of disease duration on the association between serum albumin and mucosal healing in patients with ulcerative colitis

Serum Albumin to Globulin Ratio is Associated with the Presence and Severity of Inflammatory Bowel Disease

Effect of disease duration on the association between C-reactive protein-albumin ratio and endoscopic activity in ulcerative colitis

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