Effect of disease duration on the association between serum albumin and mucosal healing in patients with ulcerative colitis.

Published on Jun 1, 2021in BMJ Open Gastroenterology
· DOI :10.1136/BMJGAST-2021-000662
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Abstract
OBJECTIVE Serum albumin is used as a marker of acute inflammation. Several studies have addressed the association between serum albumin and clinical outcome in patients with ulcerative colitis (UC). While mucosal healing (MH) has been indicated as the therapeutic goal for UC, the association between serum albumin and MH remains unclear. We evaluated this issue in patients with UC overall and explored whether duration of UC affected this association. DESIGN This cross-sectional study recruited consecutive patients with UC. Study subjects consisted of 273 Japanese patients with UC. Serum albumin was divided into tertiles based on its distribution in all study subjects. One endoscopy specialist was responsible for measuring partial MH and MH, which were defined as a Mayo endoscopic subscore of 0-1 and 0, respectively. The association between serum albumin and clinical outcomes was assessed by multivariate logistic regression. RESULTS Rates of clinical remission, partial MH and MH were 57.9%, 63% and 26%, respectively. Only high serum albumin (>4.4 mg/dL) was significantly positively associated with MH (OR 2.29 (95% CI: 1.03 to 5.29), p for trend=0.043). In patients with short UC duration (<7 years) only, high serum albumin was significantly positively associated with MH and clinical remission. In patients with long UC duration (≥7 years), in contrast, no association between serum albumin and clinical outcomes was found. CONCLUSION In Japanese patients with UC, serum albumin was significantly positively associated with MH. In patients with short UC duration, serum albumin might be a useful complementary marker for MH.
References34
Newest
#1Dan Turner (HUJI: Hebrew University of Jerusalem)H-Index: 57
#2Amanda RicciutoH-Index: 11
Last. Axel Dignass (Goethe University Frankfurt)H-Index: 33
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#1Katsuyoshi Matsuoka (Toho University)H-Index: 12
#1Katsuyoshi Matsuoka (Toho University)H-Index: 16
Last. Tadakazu Hisamatsu (Kyorin University)H-Index: 45
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#1Kana Shiraishi (Ehime University)H-Index: 1
#2Shinya Furukawa (Ehime University)H-Index: 26
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Background Serum globulin is an inflammation marker. To date, no evidence regarding the association between serum globulin and disease activity in patients with ulcerative colitis has been reported. Aims We evaluated the association between serum globulin and endoscopic activity in patients with ulcerative colitis. Methods Serum globulin was divided into tertiles based on the distribution of study subjects (low globulin, ≤ 2.7 g/dl (reference); moderate globulin, 2.7-3.1 g/dl; and high globulin,...
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#1David C Evans (OhioHealth)H-Index: 1
#1David C. Evans (OhioHealth)H-Index: 30
Last. Gordon L. Jensen (UVM: University of Vermont)H-Index: 55
view all 7 authors...
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#1Kana Shiraishi (Ehime University)H-Index: 1
#2Shinya Furukawa (Ehime University)H-Index: 26
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#1Shinya Furukawa (Ehime University)H-Index: 26
#2Sen YagiH-Index: 2
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#1Małgorzata Krzystek-Korpacka (Wrocław Medical University)H-Index: 21
#2Radosław Kempiński (Wrocław Medical University)H-Index: 5
Last. Katarzyna Neubauer (Wrocław Medical University)H-Index: 12
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