Yagi Sen, Furukawa Shinya, Shiraishi Kana, Miyake Teruki, Tange Kazuhiro, Hashimoto Yu, Kitahata Shogo, Kawamura Tomoe, Ninomiya Tomoyuki, Mori Kenichirou, Suzuki Seiyuu, Shibata Naozumi, Murakami Hidehiro, Ohashi Katsuhisa, Hasebe Aki, Tomida Hideomi, Yamamoto Yasunori, Takeshita Eiji, Ikeda Yoshio, Hiasa Yoichi
Department of Internal Medicine, Saiseikai Matsuyama Hospital, Matsuyama, Japan.
Health Services Center, Ehime University, Matsuyama, Japan.
Ann Coloproctol. 2023 Apr;39(2):155-163. doi: 10.3393/ac.2021.01032.0147. Epub 2022 Mar 30.
The albumin to globulin ratio (AGR) is a recognized chronic inflammation marker. No evidence regarding the relationship between AGR level and ulcerative colitis (UC) exists. The aim of this study was to evaluate the association between AGR and clinical outcomes among Japanese subjects with UC.
The study subjects consisted of 273 Japanese individuals with UC. AGR was divided into 4 categories (low, moderate, high, and very high). The definition of complete mucosal healing (MH) was based on the Mayo endoscopic subscore of 0. Clinical remission (CR) was defined as no rectal bleeding and no abnormally high stool frequency (<3 times per day).
The percentage of MH was 26.4%. High AGR and very high AGR were significantly positively correlated with CR (adjusted odds ratio [OR], 5.85; 95% confidence interval [CI], 2.52-14.18 and adjusted OR, 4.97; 95% CI, 2.14-12.04) and complete MH (adjusted OR, 4.03; 95% CI, 1.56-11.51 and adjusted OR, 5.22; 95% CI, 1.97-14.89), respectively after adjustment for confounding factors (P for trend=0.001). Only in the low C-reactive protein (CRP) group (≤0.1 mg/dL), very high AGR was significantly positively correlated with complete MH but not CR (adjusted OR, 4.38; 95% CI, 1.06-21.77; P for trend=0.017). In the high CRP group, no correlation between AGR and complete MH was found.
Among Japanese patients with UC, AGR may be independently positively correlated with complete MH. In particular, among UC patients with low CRP, AGR might be a useful complementary marker for complete MH.
白蛋白与球蛋白比值(AGR)是一种公认的慢性炎症标志物。目前尚无关于AGR水平与溃疡性结肠炎(UC)之间关系的证据。本研究旨在评估日本UC患者中AGR与临床结局之间的关联。
研究对象为273名日本UC患者。AGR分为4类(低、中、高和非常高)。完全黏膜愈合(MH)的定义基于梅奥内镜亚评分为0。临床缓解(CR)定义为无直肠出血且大便频率无异常增高(每天<3次)。
MH的百分比为26.4%。高AGR和非常高AGR与CR(校正比值比[OR],5.85;95%置信区间[CI],2.52 - 14.18和校正OR,4.97;95%CI,2.14 - 12.04)以及完全MH(校正OR,4.03;95%CI,1.56 - 11.51和校正OR,5.22;95%CI,1.97 - 14.89)分别在调整混杂因素后显著正相关(趋势P = 0.001)。仅在低C反应蛋白(CRP)组(≤0.1mg/dL)中,非常高AGR与完全MH显著正相关,但与CR无关(校正OR,4.38;95%CI,1.06 - 21.77;趋势P = 0.017)。在高CRP组中,未发现AGR与完全MH之间存在相关性。
在日本UC患者中,AGR可能与完全MH独立正相关。特别是在低CRP的UC患者中,AGR可能是完全MH的一个有用的补充标志物。