Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, Seoul National University College of Medicine, Seoul, Korea.
J Pediatr Gastroenterol Nutr. 2013 Nov;57(5):570-5. doi: 10.1097/MPG.0b013e31829e264e.
Several studies have indicated that plasma citrulline levels reflect the extent of mucosal injury of the small intestine. This study was performed to determine whether plasma citrulline levels correlate with the disease activity in pediatric patients with Crohn disease (CD).
A total of 63 CD and 23 ulcerative colitis (UC) patients were included in this study. Disease severity was assessed by pediatric CD activity index (PCDAI), pediatric UC activity index, simplified endoscopic activity score for CD, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR). The correlations among these variables and plasma citrulline levels were evaluated. We performed subgroup analysis whether correlations between plasma citrulline levels and disease activity depend on small bowel involvement in patients with CD.
The plasma citrulline levels correlated negatively with CRP (r = -0.332, P = 0.008), ESR (r = -0.290, P = 0.022), and PCDAI (r = -0.424, P = 0.001) in patients with CD. The plasma citrulline levels were significantly lower in patients with jejunal involvement than in those without (P = 0.027). In subgroup analysis, patients with CD with jejunal involvement showed significantly negative correlations of plasma citrulline levels with CRP (r = -0.628, P = 0.016) and PCDAI (r = -0.632, P = 0.015); however, patients with CD without jejunal involvement revealed no correlations of plasma citrulline levels with CRP and PCDAI. There were no significant correlations between plasma citrulline levels and simplified endoscopic activity score for CD. There were no significant correlations of plasma citrulline levels with CRP, ESR, and pediatric UC activity index in patients with UC.
Plasma citrulline levels correlated with disease severity as measured by PCDAI, CRP, and ESR in pediatric patients with CD with jejunal involvement.
多项研究表明，血浆瓜氨酸水平反映了小肠黏膜损伤的程度。本研究旨在确定血浆瓜氨酸水平是否与小儿克罗恩病（CD）患者的疾病活动度相关。
本研究共纳入 63 例 CD 和 23 例溃疡性结肠炎（UC）患者。疾病严重程度通过儿科 CD 活动指数（PCDAI）、儿科 UC 活动指数、简化内镜 CD 活动评分、C 反应蛋白（CRP）和红细胞沉降率（ESR）评估。评估这些变量与血浆瓜氨酸水平之间的相关性。我们进行了亚组分析，以确定 CD 患者中血浆瓜氨酸水平与疾病活动度之间的相关性是否依赖于小肠受累。
CD 患者的血浆瓜氨酸水平与 CRP（r = -0.332，P = 0.008）、ESR（r = -0.290，P = 0.022）和 PCDAI（r = -0.424，P = 0.001）呈负相关。空肠受累的 CD 患者血浆瓜氨酸水平显著低于无空肠受累的患者（P = 0.027）。在亚组分析中，空肠受累的 CD 患者的血浆瓜氨酸水平与 CRP（r = -0.628，P = 0.016）和 PCDAI（r = -0.632，P = 0.015）呈显著负相关；然而，无空肠受累的 CD 患者的血浆瓜氨酸水平与 CRP 和 PCDAI 无相关性。血浆瓜氨酸水平与简化内镜 CD 活动评分无显著相关性。UC 患者的血浆瓜氨酸水平与 CRP、ESR 和儿科 UC 活动指数无显著相关性。
空肠受累的 CD 患儿的血浆瓜氨酸水平与 PCDAI、CRP 和 ESR 等疾病严重程度指标相关。
