Inflammatory Indexes for Assessing the Severity and Disease Progression of Ulcerative Colitis: A Single-Center Retrospective Study

Abstract

BackgroundActive and severe ulcerative colitis (UC) and non-response to 5-aminosalicylic acid (5-ASA) are related to poor outcomes and should be accurately identified. Several integrated inflammatory indexes are potentially useful to assess the disease severity in patients with acute or critical diseases but are underexplored in patients with UC.MethodsPatients with UC consecutively admitted to our hospital between January 2015 and December 2020 were retrospectively grouped according to the activity and severity of UC and response to 5-ASA. The neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), neutrophil-to-platelet ratio (NPR), platelet-to-albumin ratio (PAR), C-reactive protein-to-albumin ratio (CAR), and C-reactive protein-to-lymphocyte ratio (CLR) were calculated. The areas under receiver operating characteristic curves (AUC) were calculated.ResultsOverall, 187 patients with UC were included, of whom 151 were active, 55 were severe, and 14 were unresponsive to 5-ASA. The active UC group had significantly higher NLR, PLR, SII, and PAR levels. SII had the greatest predictive accuracy for active UC, followed by PLR, PAR, and NLR (AUC = 0.647, 0.641, 0.634, and 0.626). The severe UC group had significantly higher NLR, PLR, SII, PAR, CAR, and CLR levels. CLR had the greatest predictive accuracy for severe UC, followed by CAR, PLR, SII, NLR, and PAR (AUC = 0.732, 0.714, 0.693, 0.669, 0.646, and 0.63). The non-response to the 5-ASA group had significantly higher CAR and CLR levels. CAR had a greater predictive accuracy for non-response to 5-ASA than CLR (AUC = 0.781 and 0.759).ConclusionSII, CLR, and CAR may be useful for assessing the severity and progression of UC, but remain not optimal.

Which inflammatory marker might be the best indicator for sacroiliitis?

“…36 Additionally, high CLR levels have been associated with various types of cancer such as lung cancer, 37 nasopharyngeal carcinoma, 38 gastric cancer, 39 and inflammatory bowel disease. 40 CRP-derived marker, CLR, has been introduced as a marker of inflammation in various diseases including thyroiditis, 41 hepatitis, 42 and Covid-19 infection. 43 Just like sacroiliitis, these conditions are characterized by inflammation.…”

“…These consist of infectious ailments like SARS‐CoV‐2 infection, 34 infections at the surgical site, 35 and periprosthetic joint infection 36 . Additionally, high CLR levels have been associated with various types of cancer such as lung cancer, 37 nasopharyngeal carcinoma, 38 gastric cancer, 39 and inflammatory bowel disease 40 . CRP‐derived marker, CLR, has been introduced as a marker of inflammation in various diseases including thyroiditis, 41 hepatitis, 42 and Covid‐19 infection 43 .…”

Can inflammatory indexes predict the spontaneous passage of common bile duct stones?

“…Calculations were made as they were defined in the literature. 5 The CAR and CLR values were obtained by the division of the CRP levels (mg/L), the albumin (gr/dl), and lymphocyte values (10 3 /mm 3 ). The NLR was calculated as the neutrophil counts (10 3 /mm 3 ) divided by the lymphocyte counts (10 3 /mm 3 ).…”

“…For SIII, neutrophil counts (10 3 /mm 3 ) were multiplied by the platelet counts (10 3 /mm 3 ) and divided by the lymphocyte counts (10 3 /mm 3 ). 5…”

“…2,3 The obstruction of the bile flow with CBDS is an inflammatory condition, and inflammatory indexes (IIs) present prognostic significances in inflammatory conditions. 4,5 There is currently a scarcity of data regarding the spontaneous discharge of the stones. In addition to patient characteristics, this study aimed to retrospectively delineate whether IIs might associate with the spontaneous clearance of CBDSs before an ERCP.…”