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2000
Volume 4, Issue 1
  • ISSN: 2666-2906
  • E-ISSN: 2666-2914

Abstract

Introduction

Inflammatory Bowel Disease (IBD) comprises ulcerative colitis (UC) and Crohn’s disease (CD). Serum-based non-invasive biomarkers are suggested for endoscopic and histological healing in clinical practice.

Aims

The aim of this study was to investigate the utility of serum-based markers to predict severity, histological activity, and rehospitalization in ulcerative colitis.

Materials and Methods

This was a cross-sectional study that was performed in a tertiary care center from October 2022 to March 2023. Diagnosis of ulcerative colitis on the basis of clinical history, imaging findings, flexible sigmoidoscopy/colonoscopy findings, and histopathology reports and agreed to participate were included. All the data, including blood parameters, were analysed.

Results

C Reactive Protein (CRP)/albumin (AUC 0.821; 95% CI: 0.732 to 0.891, cut off point of >2.57), (AUC 0.875; 95% CI: 0.794 to 0.933, cut off point of >4.13) was the best predictor for correctly predicting endoscopic severity (UCEIS) and active histological inflammation and also a good predictor of re-hospitalization in the last 6 months (AUC 0.814; 95% CI: 0.724 to 0.885, cut off point of >6.34) as compared to red cell distribution width (RDW)/albumin (AUC 0.598; 95% CI: 0.495 to 0.695), (AUC 0.537; 95% CI: 0.434 to 0.637), which was non-significant. RDW/Albumin (AUC 0.793; 95% CI: 0.701 to 0.868) also predicts 6-month rehospitalization significantly but less as compared to CRP/Albumin.

Conclusion

In ulcerative colitis, the CRP/ALB ratio was a strong predictor of endoscopic severity, histologic disease activity, and rehospitalization in 6 months. It can be used to predict treatment response and as an indirect biomarker for mucosal healing.

© 2025 Bentham Science Publishers
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2025-09-26

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References

  1. AhujaV. TandonR.K. Inflammatory bowel disease in the Asia–Pacific area: A comparison with developed countries and regional differences.J. Dig. Dis.201011313414710.1111/j.1751‑2980.2010.00429.x20579217
     [Google Scholar]
  2. RaineT. BonovasS. BurischJ. KucharzikT. AdaminaM. AnneseV. BachmannO. BettenworthD. ChaparroM. Czuber-DochanW. EderP. EllulP. FidalgoC. FiorinoG. GionchettiP. GisbertJ.P. GordonH. HedinC. HolubarS. IacucciM. KarmirisK. KatsanosK. KopylovU. LakatosP.L. LytrasT. LyutakovI. NoorN. PellinoG. PiovaniD. SavarinoE. SelvaggiF. VerstocktB. SpinelliA. PanisY. DohertyG. ECCO guidelines on therapeutics in ulcerative colitis: Medical treatment.J. Crohn’s Colitis202216121710.1093/ecco‑jcc/jjab17834635919
     [Google Scholar]
  3. AbrahamC. ChoJ.H. Inflammatory bowel disease.N. Engl. J. Med.2009361212066207810.1056/NEJMra080464719923578
     [Google Scholar]
  4. MagroF. GionchettiP. EliakimR. ArdizzoneS. ArmuzziA. Barreiro-de AcostaM. BurischJ. GecseK.B. HartA.L. HindryckxP. LangnerC. LimdiJ.K. PellinoG. ZagórowiczE. RaineT. HarbordM. RiederF. European Crohn’s and Colitis Organisation [ECCO] Third European evidence-based consensus on diagnosis and management of ulcerative colitis. Part 1: Definitions, diagnosis, extra-intestinal manifestations, pregnancy, cancer surveillance, surgery, and ileo-anal pouch disorders.J. Crohn’s Colitis201711664967010.1093/ecco‑jcc/jjx00828158501
     [Google Scholar]
  5. SturmA. MaaserC. CalabreseE. AnneseV. FiorinoG. KucharzikT. VavrickaS.R. VerstocktB. van RheenenP. TolanD. TaylorS.A. RimolaJ. RiederF. LimdiJ.K. LaghiA. KrustiņšE. KotzeP.G. KopylovU. KatsanosK. HalliganS. GordonH. González LamaY. EllulP. EliakimR. CastiglioneF. BurischJ. Borralho NunesP. BettenworthD. BaumgartD.C. StokerJ. European Crohn’s and Colitis Organisation [ECCO] and the European Society of Gastrointestinal and Abdominal Radiology [ESGAR] ECCO-ESGAR guideline for diagnostic assessment in IBD part 2: IBD scores and general principles and technical aspects.J. Crohn’s Colitis201913327328410.1093/ecco‑jcc/jjy11430137278
     [Google Scholar]
  6. AcarturkG. AcayA. DemirK. UluM.S. AhsenA. YukselS. Neutrophil-to-lymphocyte ratio in inflammatory bowel disease – As a new predictor of disease severity.Bratisl. Med. J.2015116421321710.4149/BLL_2015_04125773946
     [Google Scholar]
  7. BittonA. PeppercornM.A. AntonioliD.A. NilesJ.L. ShahS. BousvarosA. RansilB. WildG. CohenA. Deb EdwardesM.D. StevensA.C. Clinical, biological, and histologic parameters as predictors of relapse in ulcerative colitis.Gastroenterology20011201132010.1053/gast.2001.2091211208709
     [Google Scholar]
  8. GuptaR.B. HarpazN. ItzkowitzS. HossainS. MatulaS. KornbluthA. BodianC. UllmanT. Histologic inflammation is a risk factor for progression to colorectal neoplasia in ulcerative colitis: A cohort study.Gastroenterology200713341099110510.1053/j.gastro.2007.08.00117919486
     [Google Scholar]
  9. SchoepferA.M. BeglingerC. StraumannA. SafroneevaE. RomeroY. ArmstrongD. SchmidtC. TrummlerM. PittetV. VavrickaS.R. Fecal calprotectin more accurately reflects endoscopic activity of ulcerative colitis than the Lichtiger Index, C-reactive protein, platelets, hemoglobin, and blood leukocytes.Inflamm. Bowel Dis.201319233234110.1097/MIB.0b013e318281006623328771
     [Google Scholar]
  10. Jauregui-AmezagaA. GeeritsA. DasY. LemmensB. SagaertX. BessissowT. LobatónT. FerranteM. Van AsscheG. BisschopsR. GeboesK. De HertoghG. VermeireS. A simplified Geboes score for ulcerative colitis.J. Crohn’s Colitis201711330531327571771
     [Google Scholar]
  11. CakalB. AkozA.G. UstundagY. YalinkilicM. UlkerA. AnkaraliH. Red cell distribution width for assessment of activity of inflammatory bowel disease.Dig. Dis. Sci.200954484284710.1007/s10620‑008‑0436‑218716874
     [Google Scholar]
  12. DonBR KaysenG Poor nutritional status and inflammation: Serum albumin: Relationship to inflammation and nutrition.InSeminars in Dialysis Blackwell Science IncOxford, UK20041710.1111/j.0894‑0959.2004.17603.x
     [Google Scholar]
  13. FaircloughE. CairnsE. HamiltonJ. KellyC. Evaluation of a modified early warning system for acute medical admissions and comparison with C-reactive protein/albumin ratio as a predictor of patient outcome.Clin. Med.200991303310.7861/clinmedicine.9‑1‑3019271597
     [Google Scholar]
  14. WuJ. TanW. ChenL. HuangZ. MaiS. Clinicopathologic and prognostic significance of C-reactive protein/albumin ratio in patients with solid tumors: An updated systemic review and meta-analysis.Oncotarget2018917139341394710.18632/oncotarget.2417229568406
     [Google Scholar]
  15. QinG. TuJ. LiuL. LuoL. WuJ. TaoL. ZhangC. GengX. ChenX. AiX. ShenB. PanW. Serum albumin and C-reactive protein/albumin ratio are useful biomarkers of Crohn’s disease activity.Med. Sci. Monit.2016224393440010.12659/MSM.89746027848931
     [Google Scholar]
  16. MolnarT. FarkasK. SzepesZ. NagyF. NyariT. WittmannT. RDW can be a useful additional marker in diagnosing Crohn’s disease and ulcerative colitis.Dig. Dis. Sci.200853102828282910.1007/s10620‑008‑0345‑418629645
     [Google Scholar]
  17. SongC.S. ParkD.I. YoonM.Y. SeokH.S. ParkJ.H. KimH.J. ChoY.K. SohnC.I. JeonW.K. KimB.I. Association between red cell distribution width and disease activity in patients with inflammatory bowel disease.Dig. Dis. Sci.20125741033103810.1007/s10620‑011‑1978‑222147246
     [Google Scholar]
  18. TrueloveS.C. WittsL.J. Cortisone in ulcerative colitis; Final report on a therapeutic trial.BMJ1955249471041104810.1136/bmj.2.4947.104113260656
     [Google Scholar]
  19. TravisS.P.L. SchnellD. KrzeskiP. AbreuM.T. AltmanD.G. ColombelJ.F. FeaganB.G. HanauerS.B. LémannM. LichtensteinG.R. MarteauP.R. ReinischW. SandsB.E. YacyshynB.R. BernhardtC.A. MaryJ.Y. SandbornW.J. Developing an instrument to assess the endoscopic severity of ulcerative colitis: The ulcerative colitis endoscopic index of severity (UCEIS).Gut201261453554210.1136/gutjnl‑2011‑30048621997563
     [Google Scholar]
  20. SatsangiJ. SilverbergM.S. VermeireS. ColombelJ.F. The Montreal classification of inflammatory bowel disease: controversies, consensus, and implications.Gut200655674975310.1136/gut.2005.08290916698746
     [Google Scholar]
  21. FrøslieK.F. JahnsenJ. MoumB.A. VatnM.H. IBSEN Group Mucosal healing in inflammatory bowel disease: Results from a Norwegian population-based cohort.Gastroenterology2007133241242210.1053/j.gastro.2007.05.05117681162
     [Google Scholar]
  22. KimDB LeeKM LeeJM ChungYY SungHJ Correlation between histological activity and endoscopic, clinical, and serologic activities in patients with ulcerative colitis.Gastroenterol. Res. Pract.2016201610.1155/2016/5832051
     [Google Scholar]
  23. DubinskyM.C. OfmanJ.J. UrmanM. TarganS.R. SeidmanE.G. Clinical utility of serodiagnostic testing in suspected pediatric inflammatory bowel disease.Am. J. Gastroenterol.200196375876510.1111/j.1572‑0241.2001.03618.x11280547
     [Google Scholar]
  24. SakuraiT. SarutaM. Positioning and usefulness of biomarkers in inflammatory bowel disease.Digestion20231041304110.1159/00052784636404714
     [Google Scholar]
  25. YeşilA. ŞenateşE. Bayoğluİ.V. ErdemE.D. DemirtunçR. ÖvünçA.O.K. Red cell distribution width: A novel marker of activity in inflammatory bowel disease.Gut Liver20115446046710.5009/gnl.2011.5.4.46022195244
     [Google Scholar]
  26. ZhaoN. HuW. WuZ. WuX. LiW. WangY. ZhaoH. The red blood cell distribution width-albumin ratio: A promising predictor of mortality in stroke patients.Int. J. Gen. Med.2021143737374710.2147/IJGM.S32244134326660
     [Google Scholar]
  27. RuotB. BéchereauF. BayleG. BreuilléD. ObledC. The response of liver albumin synthesis to infection in rats varies with the phase of the inflammatory process.Clin. Sci.2002102110711410.1042/cs102010711749667
     [Google Scholar]
  28. RanzaniO.T. ZampieriF.G. ForteD.N. AzevedoL.C.P. ParkM. C-reactive protein/albumin ratio predicts 90-day mortality of septic patients.PLoS One201383e5932110.1371/journal.pone.005932123555017
     [Google Scholar]
  29. ChenYH WangL FengSY CaiWM ChenXF HuangZM The relationship between C-reactive protein/albumin ratio and disease activity in patients with inflammatory bowel disease.Gastroenterol. Res. Pract.20202020
     [Google Scholar]
  30. FurukawaS. YagiS. ShiraishiK. MiyakeT. TangeK. HashimotoY. KitahataS. KawamuraT. NinomiyaT. MoriK. SuzukiS. ShibataN. MurakamiH. OhashiK. HasebeA. TomidaH. YamamotoY. TakeshitaE. IkedaY. HiasaY. Effect of disease duration on the association between C-reactive protein-albumin ratio and endoscopic activity in ulcerative colitis.BMC Gastroenterol.20222213910.1186/s12876‑022‑02113‑335094678
     [Google Scholar]
  31. SayarS. KurbuzK. KahramanR. CaliskanZ. AtalayR. OzturkO. DoganayH.L. OzdilK. A practical marker to determining acute severe ulcerative colitis: CRP/albumin ratio.North. Clin. Istanb.201971495532232203
     [Google Scholar]
  32. GibsonD.J. HarteryK. DohertyJ. NolanJ. KeeganD. ByrneK. MartinS.T. BuckleyM. SheridanJ. HorganG. MulcahyH.E. CullenG. DohertyG.A. CRP/albumin ratio.J. Clin. Gastroenterol.2018526e48e5210.1097/MCG.000000000000088428737646
     [Google Scholar]
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Utility of Serum-Based Markers to Predict Severity, Histological Activity, and Rehospitalisation in Ulcerative Colitis
Int J Gastroenterol Hepatol Dis 4, E26662906334998 (2025); https://doi.org/10.2174/0126662906334998241226071645
/content/journals/ijghd/10.2174/0126662906334998241226071645
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  • Article Type:     Review Article
Keyword(s): c-reactive protein to albumin ratio; colorectal cancers; crohn’s disease; red cell distribution width to albumin ratio; rehospitalization; Ulcerative colitis

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