Serum Procalcitonin Values Relate to Disease Activity in Patients with Inflammatory Bowel Diseases

Abstract

Objective: In inflammatory bowel disease (IBD) patients, the correlation between disease activity and serum procalcitonin (SPCT) values remains elusive. By using a number of clinical and laboratory phenotypes of disease activity in conjunction with the degree of mucosal inflammation in patients with ulcerative colitis (UC), we sought to determine whether the blood SPCT levels of IBD patients could be useful as a biomarker. Methods: This retrospective case-control study was conducted with 132 UC patients, 83 Crohn’s disease (CD) patients, and 72 healthy controls (HCs). In UC, endoscopic and clinical activity were identified using the Mayo Clinical Scoring System (MCS), and the histological activity index (HAI) was calculated using the Truelove and Richards technique. The Crohn's disease activity index (CDAI) of CD patients was calculated. The Montreal classification was preferred for determining disease localization in IBD patients. Results: The median SPCT levels were higher in the UC and CD patients compared to the HC (0.07 vs 0.26 vs 0.03 ng/ml, respectively, p<0.001). The MCS of UC and the CDAI of CD patients having active disease showed higher median SPCT levels than the patients in remission (p<0.001, p=0.033, respectively). The CD patients with a fistula and/or an abscess had higher SPCT concentrations than CD patients without a fistula and/or abscess (p<0.001). In the UC group, SPCT levels were positively correlated to the MCS and HAI values (p<0.001 for both values). Conclusions: For the disease activity of IBDs, SPCT values may be a cost-effective and practical biomarker.

Keywords

• Disease activity
• Inflammatory bowel disease
• Procalcitonin

İnflamatuvar Bağırsak Hastalarında Serum Prokalsitonin Değerleri Hastalık Aktivitesi ile İlişkilidir

Abstract

Amaç: İnflamatuar barsak hastalıkları (İBH) olan vakalarda hastalık aktivitesi ile serum prokalsitonin (SPCT) değerleri arasındaki korelasyonlar ile ilgili veriler çelişkili olup tam olarak belirlenememiştir. Çalışmamızda ülseratif kolitli (ÜK) hastalarda mukozal inflamasyonun derecesine ilave olarak, İBH hastalık aktivitesinin değişik klinik ve laboratuvar fenotipleri ile SPCT düzeyleri değerlendirilmiş ve SPCT’nin yararlı bir biyobelirteç olup olamayacağı araştırılmıştır. Yöntem: Bu retrospektif vaka-kontrol çalışmasına 132 ÜK hastası, 83 Crohn hastalığı (CH) vakası ve 72 sağlıklı kontrol (SK) dahil edilmiştir. ÜK klinik aktivitesi için Mayo klinik skorlama sistemi (MKS), histolojik aktivite indeksi (HAİ) için Truelove ve Richards yöntemleri kullanıldı. CH‘da klinik aktivite için Crohn hastalığı aktivite indeksi (CHAİ) kullanıldı. İBH’nın endoskopik lokalizasyonu Montreal sınıflandırmasına göre yapılmıştır. Bulgular: Median SPCT düzeyleri ÜK ve CH hastalarında SK’'e göre daha yüksekti (0.07 vs 0.26 vs 0.03 ng/ml, sırasıyla, p<0.001). ÜK’de MKS ve CH’da CHAİ’e göre aktif hastalığı olanlarda remisyonda olanlara göre median SPCT değerleri daha yüksekti (p<0.001, p=0.033, sırasıyla). Fistülü ve/veya apsesi olan CH vakalarında olmayanlara göre daha yüksek median SPCT seviyeleri tespit edildi (p<0,001). ÜK hastalarında SPCT düzeyleri ile MKS ve HAİ değerleri arasında pozitif korelasyon saptandı (p<0.001 her ikisi için). Sonuç: Hastalık aktivitesinin belirlenmesinde İBH’da SPCT değerleri uygun maliyetli ve pratik bir biyobelirteç olarak kullanılabilir.

Keywords

• Hastalık aktivitesi
• İnflamatuar bağırsak hastalığı
• Prokalsitonin

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