Association between C-reactive protein-albumin ratio and endoscopic activity in ulcerative colitis patients
Key Takeaways
This cross-sectional study found that the C-reactive protein-albumin ratio (CAR) was significantly associated with moderate-to-severe endoscopic activity in patients with ulcerative colitis (UC).
Investigators did not find a significant association between CAR and mucosal healing (MH) or clinical remission, suggesting that CAR can be used as a marker of disease, but not remission.
Longitudinal and interventional studies are needed to confirm the association between CAR and endoscopic activity.
UC affects an increasing number of patients worldwide. While the majority of patients have mild or moderate disease activity, 10-20% of patients have severe UC. Early detection of changes in disease activity are critical to guiding treatment plans and preventing complications.
Why This Study Matters
Colonoscopy is currently the gold standard for determining UC disease activity; however, there is currently an unmet need for a serum biomarker that can report on disease activity with similar sensitivity and specificity as a colonoscopy, but more easily and less invasive. While previous studies have demonstrated an association between CAR and disease prognosis in patients with inflammatory bowel disease (IBD), the utility of CAR as a biomarker in UC has yet to be explored. This study evaluated the link between CAR and clinical outcomes in Japanese patients with UC.
Study Design
The study consisted of 273 participants with UC. Outcomes of the study included: endoscopic activity; MH; and clinical remission. Clinical remission was defined as the absence of both high stool frequency (< 3 per day) and rectal bleeding. Subjects were divided into three CAR groups (low, moderate, and high).
Results and Conclusions
Investigators found a significant positive association between CAR and moderate to severe endoscopic activity. When investigators took into account the disease duration, high CAR was associated with moderate to severe endoscopic activity in the long-duration group (> 7 years), but not the short-duration group (≤ 7 years). Regardless of disease duration, CAR was not associated with clinical remission or MH.
Related Research
Consider these findings from similar research studies:
CAR is a better predictor of patients with severe ulcerative colitis than C-reactive protein levels alone (Source).
CAR is predictive of infliximab failure and need for colectomy in patients with steroid-refractory acute severe ulcerative colitis (Source).
Original Source
Furukawa S, Yagi S, Shiraishi K, et al. Effect of disease duration on the association between C-reactive protein-albumin ratio and endoscopic activity in ulcerative colitis. BMC Gastroenterol. 2022;22(1):39.