DIAGNOSTIC VALUE OF LABORATORY AND FECAL BIOMARKERS FOR DETERMINING THE ACTIVITY OF ULCERATIVE COLITIS

Abstract

Aim. Determination of the diagnostic value of biomarkers in a non-invasive assessment of intestinal inflammation in patients with ulcerative colitis. Object and methods. We examined 60 patients with ulcerative colitis, in 36 (60.0%) – according to the combined Mayo index, a moderate degree of exacerbation of ulcerative colitis was diagnosed, in 24 (40.0%) – a severe degree of disease activity was diagnosed. The content of α1-antitrypsin (α1-AT) in serum and feces, the level of fecal calprotectin (FC) and myeloperoxidase (MPO), as well as the content of C-reactive protein (CRP) were determined. Results. In patients with ulcerative colitis, the content of fecal α1-AT was increased 4 times (p<0.05), calprotectin (p<0.05) in 26 times and myeloperoxidase (p<0.05) in 35 times. The level of CRP in patients with a severe degree of disease activity increased in 2 times (p<0.05), the content of α1-AT in the feces – in 3 times (p<0.05) and MPO – in 4.5 times (p<0,05). To assess the severe degree of activity of ulcerative colitis, the diagnostic model with feces myeloperoxidase content showed the highest quality (the area under the ROCcurve was 0.874, p<0.0001). The second likely marker was serum CRP level (sensitivity 63.2% and specificity 71.4%). The conclusion. Based on the results of the ROC analysis, it is advisable to determine the level of fecal biomarkers for the diagnosis of ulcerative colitis: area under the ROC-curve for FC is 0.993, area under the ROC-curve for MPO is 0.994. Fecal myeloperoxidase (sensitivity 92.9% and specificity 76.0%) can be used as a non-invasive marker for assessing the degree of activity of ulcerative colitis.

Keywords

• ulcerative colitis
• diagnosis
• non-invasive markers of inflammation