Assessment of inflammatory markers in ulcerative colitis and association with the disease

Aim: In daily routine practice, non-invasive tests are needed in addition to symptoms to determine activation in patients with ulcerative colitis (UC). In this study, it was aimed to compare the results of non-invasive tests used frequently at the time of diagnosis of patients diagnosed with UC with endoscopic severity. Material and Methods: This retrospective cohort study was carried out on 202 patients between 2018 and 2022. The white blood count (WBC), mean platelet volume (MPV), hemoglobin (HB), hematocrit (Hct), C-reactive protein (CRP), albumin, neutrophil-lymphocyte ratio (NLR), CRP-albumin ratio (CAR), plateletlymphocyte ratio (PLR), and lymphocyte-monocyte ratio (LMR) of the patients were calculated at the time of diagnosis. The severity of UC was assessed via colonoscopy using the Mayo Endoscopic Subscore (Mayo Score). In addition, patients with active UC were re-evaluated during remission to calculate the predictive values of tests in UC activation and severity. Results: There was a significant correlation between the Mayo Subscore and CRP (r: 0.34, P < 0.01), WBC (r: 0.23, P = 0.01), HB (r: -0.23, P = 0.01), NLR (r: 0.49, P < 0.01), CAR (r: 0.51, P < 0.01), PLR (r: 0.32, P < 0.01), and LMR (r: -0.34, P < 0.01). The sub-assessment, taking colon involvement into consideration, showed a correlation between the Mayo Subscore and NLR and CAR with pancolitis, left colon involvement, and distal colitis. The highest area under the curve (AUC) value, found in the tests, was with the CAR (0.919). When the CAR cut-off value was taken as 0.11, the sensitivity was 80.2%, and the specificity was 94.4%, indicating UC activation. Discussion: Inflammatory markers in UC have adequate sensitivity in indicating activation, and they also aid in the identification of severity of involvement in patients.