Correlation Of Potential Inflammatory Parameters For Predicting Endoscopic Activity In Ulcerative Colitis

Objective: At present,many indicators reflect the clinical disease activity of UC.However,commonly used inflammatory markers do not show good utility for indicating endoscopic disease activity.The purpose of this study was to evaluate hs-CRP,CAR,inflammatory markers,and CBC related parameters in patients with UC as simple,noninvasive,and independent markers of EA.Methods: Retrospectively,the clinical data of386 patients with UC were analyzed.The MES was used to evaluate endoscopic disease activity.All included patients were defined as the MES-All group;those with extensive colitis(E3)were defined as the MES-E3 group.Statistical methods were used to compare the differences between groups,and Spearman correlation analysis and multivariate Logistic regression analysis were used to analyze the correlation.The predictive value of laboratory parameters to UC was determined by constructing ROC curve.Results: For patients in the MES-All or MES-E3 group,hs-CRP,CAR,neutrophil to lymphocyte ratio(NLR),and platelet to lymphocyte ratio(PLR)were significantly higher in EA UC patients than in those with mucosal healing.The mean platelet volume(MPV)and lymphocyte to monocyte ratio were significantly lower in active disease than in the patient’s remission(P<0.001).Multivariate logistic regression analysis showed that hsCRP,CAR,NLR,and PLR identified UC EA,while decreased MPV reflected inflammatory activity in the UC mucosa.ROC analysis showed that in the MES-All and MES-E3 groups,the cutoff values of hs-CRP activity under endoscopy were 5.32 mg/L(AUC 0.850,sensitivity 77.6%,specificity 81.9%)and 5.16 mg/L(AUC 0.902,sensitivity86.9%,specificity 85.4%)respectively,and the cutoff values of CAR were 0.14(AUC0.853,sensitivity 76.8%,specificity 84.8%)and 0.18(AUC 0.904,sensitivity 81.8%,specificity 89.6%)respectively.Conclusion: In endoscopic grading,hs-CRP,CAR,NLR and PLR may be independent risk factors of UC EA,while the decrease of MPV may be an indicator of increased EA.Especially in patients with E3,hs-CRP and CAR are closely related to EA and show higher typing and diagnostic value than the related parameters of CBC.They are simple and non-invasive independent markers reflecting the EA of UC.