Retrospective Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. May 14, 2025; 31(18): 104206
Published online May 14, 2025. doi: 10.3748/wjg.v31.i18.104206
Role of serological biomarkers in evaluating and predicting endoscopic activity in inflammatory bowel disease
Xue Liu, Lin-Xiao Pan, Jia-Xian Pei, Tian Pu, Hong-Tao Wen, Ye Zhao
Xue Liu, Lin-Xiao Pan, Jia-Xian Pei, Tian Pu, Hong-Tao Wen, Ye Zhao, Department of Gastroenterology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China
Author contributions: Liu X, Pan LX, and Pei JX participated in the conception and design of the study and were involved in the acquisition, analysis and interpretation of data; Liu X wrote the manuscript; Pu T, Wen HT, and Zhao Y accessed and verified the study data. All authors critically reviewed and provided final approval of the manuscript; and all authors were responsible for the decision to submit the manuscript for publication.
Supported by Henan Natural Science Foundation, No. 232300421181.
Institutional review board statement: The study was reviewed and approved by the First Affiliated Hospital of Zhengzhou University Institutional Review Board (Approval No. 2024-KY-1476-002).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at E-mail address. Participants gave informed consent for data sharing.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ye Zhao, MD, Chief Physician, Professor, Department of Gastroenterology, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Road, Erqi District, Zhengzhou 450052, Henan Province, China. jamie006@126.com
Received: December 23, 2024
Revised: March 29, 2025
Accepted: April 23, 2025
Published online: May 14, 2025
Processing time: 143 Days and 21.9 Hours
Abstract
BACKGROUND

Diagnosis of inflammatory bowel disease and assessment of disease activity are fundamentally reliant on endoscopy. Nonetheless, it is costly and invasive, highlighting the necessity for more accessible and non-invasive biomarkers to assist in the diagnosis and evaluation of inflammatory bowel disease.

AIM

To examine the correlation of biomarkers with endoscopic activity, evaluate their diagnostic significance, and develop models to forecast endoscopic activity.

METHODS

We performed a retrospective single-center analysis of 365 patients with ulcerative colitis (UC), 319 with Crohn’s disease (CD) and 100 controls at the First Affiliated Hospital of Zhengzhou University from January 2022 to September 2024. The following biomarkers were analyzed: White blood cell, hemoglobin (Hb), platelet (PLT), neutrophil (N), lymphocyte (L), hematocrit (HCT), eosinophil, albumin (ALB), globulin (GLB), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), ALB/GLB (AGR), CRP/ALB (CAR), CRP/L (CLR), PLT/ALB (PAR), PLT/L (PLR), and N/L (NLR).

RESULTS

Serum N, PLT, GLB, CRP, ESR, CAR, CLR, PLR, PAR, and NLR levels were significantly elevated (P < 0.001 or P < 0.05) in the UC and CD groups compared to controls, whereas Hb, HCT, L, ALB, and AGR were reduced (P < 0.001 or P < 0.05). Aside from L and eosinophil, substantial differences were observed between mild and severe activity in UC and CD (P < 0.001 or P < 0.05). UC and CD patients who exhibited an endoscopic response after 14 weeks of treatment had elevated CRP, CAR, and CLR levels at baseline compared to endoscopic nonresponders (P < 0.01 or P < 0.05). The UC nomogram model utilizing ESR, CAR, and PAR, along with the CD nomogram model employing AGR and PAR, demonstrate predictive significance and clinical applicability for assessing endoscopic activity.

CONCLUSION

White blood cell, Hb, HCT, PLT, N, CRP, ESR, ALB, GLB, AGR, CAR, CLR, PLR, PAR and NLR are significantly correlated with the endoscopic activity of UC and CD. Patients with UC and CD exhibiting elevated CRP, CAR, and CLR levels are more inclined to respond to treatment. Our nomogram models can precisely forecast endoscopic activity.

Keywords: Inflammatory bowel disease; Ulcerative colitis; Crohn’s disease; Biomarkers; Endoscopic activity; Nomogram; Prediction model

Core Tip: This is a retrospective single-center observational study to examine the correlation of serum biomarkers with endoscopic activity of ulcerative colitis (UC) and Crohn’s disease (CD), evaluate their diagnostic significance, and develop nomogram models to forecast endoscopic activity. Many markers such as white blood cell, hemoglobin, hematocrit, platelet (PLT), neutrophil, C-reactive protein (CRP), erythrocyte sedimentation rate, albumin (ALB), globulin, ALB/globulin, CRP/ALB, CRP/lymphocyte, PLT/lymphocyte, PLT/ALB, and neutrophil/lymphocyte are associated with endoscopic activity in patients with UC and CD. We can predict endoscopic severity of UC and CD by using the nomogram models.