Association of serum bilirubin with mucosal healing in ulcerative colitis
Objective To analyze the correlation between bilirubin and ulcerative colitis(UC)and the predictive value of bilirubin level to mucosal healing(MH).Methods The levels of serum bilirubin in 386 patients with UC were retrospectively analyzed and compared in different degrees of UC.According to the distribution of all subjects,serum bilirubin was divided into quartiles and analyzed by multivariate Logistic regression analysis.The correlation between bil-irubin level,the severity of UC and inflammatory factors was analyzed.The predictive value of bilirubin level to UC was determined by constructing a ROC curve.Results There were statistically significant differences in serum TBIL and IBIL levels among different endoscopic and clinical subgroups of UC patients(P＜0.05).After adjusting for confounding factors,increased IBIL was independently positively associated with MH(OR=6.379,95％CI:2.478-16.423,trend P＜0.001)and also independently positively associated with clinical remission(CR)(OR=7.395,95％CI:1.830-29.892,trend P=0.001).ROC curve analysis indicated that the cut-off value for IBIL in predicting MH was 5.530 μmol/L(AUC=0.736,sensitivity was 77.1％,specificity was 61.6％),while the cut-off value for TBIL was 8.705 μmol/L(AUC=0.710,sensitivity was 80.0％,specificity was 56.6％).For predicting CR,the IBIL cut-off value was 7.305 μmol/L(AUC=0.744,sensitivity was 66.7％,specificity was 73.6％),and the TBIL cut-off value was 8.705 μmol/L(AUC=0.694,sensitivity was 84.4％,specificity was 50.7％).The combination of IBIL and hs-CRP for predicting MH had an AUC of 0.883(sensitivity was 84.0％,specificity was 81.9％),and for predicting CR had an AUC of 0.865(sensitivity was 76.0％,specificity was 88.9％).Conclusion The correlation between IBIL and the severity of UC disease is stronger than TBIL,and high levels of IBIL may indicate mucosal relief.A higher level of IBIL has moderate predictive value for MH,and the combination of IBIL improves the diagnostic efficacy of hs-CRP in predicting MH and CR.IBIL can serve as a supplementary evaluation indicator for distinguishing the severity of UC disease.
NETL
NSTL
万方数据
