İnflamatuar bağırsak hastalığının aktivasyonunun değerlendirilmesinde adenosin deaminaz düzeyinin kullanımı

Öz

Amaç: Günümüzde, inflamatuar barsak hastalığı (İBH) hastalarda hastalığın türünü, aktivitesinin derecesini belirleyebilen, seyrini tahmin edebilen ve tedavi yanıtını izleyebilen ideal bir laboratuvar testine hala ihtiyaç vardır. Bu çalışmada İBH olan hastalarda hastalık aktivitesi ile adenozin deaminaz ADA düzeyleri arasındaki ilişki araştırıldı. Yöntemler: Bu vaka-kontrol çalışmasına toplam olarak 92 IBH hastası [43 Crohn hastalığı (CD) ve 49 ülseratif kolit (UC)] ve 31 sağlıklı kontrol (HC) gönüllüsü dahil edildi. Hastaların yaşı, cinsiyeti, vücut kitle indeksi, hastalığın yeri ve şiddeti, ilaç tedavisi, endoskopik muayene, hemogram, C-reaktif Protein (CRP) ve ADA sonuçları retrospektif olarak değerlendirildi. Bulgular: Ortalama ADA seviyesi IBH grubunda 24,87 (9,6 - 74,9) IU/L ve HC grubunda 20,8 (13,7 - 38,9) IU/L idi. IBH ve HC grubu arasındaki fark istatistiksel olarak anlamlıydı (P<0,013), ancak UC ve CD grubu arasındaki fark istatistiksel olarak anlamlı değildi(P=0,76). Ortalama ADA düzeyi aktif UC hastalarında inaktif olanlardan anlamlı olarak yüksekti (P<0,001). Aktif UC hastalarını remisyonda UC hastalarından ayırt etmek için, eğer ADA düzeyinin eşik değeri 77,6 güven aralığında 21,64 U/L olarak kabul edilirse, duyarlılık %89 ve özgüllük %60 olarak hesaplandı. Ortalama ADA düzeyi CD grubunda HC grubuna göre anlamlı derecede yüksekti. Sonuç: ADA seviyesi, hastalığın bulunduğu yere ve etkilenen alanın boyutuna bakılmaksızın, aktif UC hastalarını remisyondaki UC hastalarından ayırmak için alternatif bir belirteç olarak kullanılabilir.

Anahtar Kelimeler

• Crohn hastalığı
• Ülseratif kolit
• Adenozin deaminaz

The value of adenosine deaminase level in assessing activation of inflammatory bowel disease

Abstract

Aim: There is still a need for an ideal laboratory test that can determine the type of disease, the degree of its activity, predict its course, and monitor treatment response in patients with inflammatory bowel disease (IBD). This study aims to investigate the relationship between disease types and activity with Adenosine deaminase (ADA) levels in patients with IBD. Methods: A total of 92 patients with IBD [43 with Crohn’s disease (CD) and 49 with ulcerative colitis (UC)] and 31 healthy control (HC) volunteers were included in this case-control study. Patients’ age, gender, body mass index, location and severity of the disease, medication, endoscopic examination, hemogram, C-reactive Protein (CRP), and ADA results were evaluated. Results: The mean ADA level was 24.87 (9.6 - 74.9) IU/L in the IBD group and 20.8 (13.7 - 38.9) IU/L in the HC group. The difference between the IBD and HC groups was statistically significant (P<0.013), while that between UC and CD groups was not (P=0.76). Mean ADA level was significantly higher in active UC patients than in inactive ones (P<0.001). To distinguish active UC patients from those in remission, a cut-off level of 21.64 U/L was determined for ADA with 77.6% confidence interval, 89% sensitivity and 60% specificity. Mean ADA level was significantly higher in the CD group compared to the HC group. Conclusion: ADA level may be used as an alternative marker to distinguish active UC patients from those in remission, regardless of the disease location and the extent of the affected area.

Keywords

• Ulcerative colitis
• Crohn’s disease
• Adenosine deaminase

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