University of Maryland School of Medicine, 22 S. Greene St., Baltimore, MD, 21201, USA.
George Washington University Hospital, Washington, DC, USA.
Dig Dis Sci. 2024 Jun;69(6):2154-2163. doi: 10.1007/s10620-024-08421-w. Epub 2024 Apr 5.
Patient-reported outcomes (PROs), such as the short CD activity index (sCDAI) and partial Mayo Score (PMS), are used to define clinical remission in IBD, but may not represent the true degree of inflammation and endoscopy is invasive. Non-invasive testing options include c-reactive protein (CRP) and fecal calprotectin (FCP).
The aim of this study was to assess the degree of correlation of non-invasive biomarkers with PROs and the impact other clinical variables can have on their levels.
We reviewed data collected from the prospective cohort, Study of a Prospective Adult Research Cohort with IBD (SPARC-IBD), comprised of over 3000 patients from 17 tertiary referral centers. Demographic and clinical variables were analyzed by disease type, disease severity was based on PROs, and baseline CRP and FCP were measured. For comparative analysis, we performed Fisher's exact test and Welch's t test, where p < 0.05 was significant.
1547 patients were included; 63% had CD, 56% were female, with an average disease duration of 13.6 years. CRP and FCP were associated with symptom severity in inflammatory CD. CRP was useful to differentiate symptoms across different disease locations in CD, whereas FCP was associated with symptom severity in Crohn's colitis only. For UC, FCP was able to distinguish symptom severity better in distal UC, whereas in extensive or pancolitis, it was useful only to distinguish severe symptoms from other categories of symptom severity.
PROs correlate with CRP and FCP; however, disease location and phenotype impact their ability to distinguish symptom severity.
患者报告的结局（PROs），如短 CD 活动指数（sCDAI）和部分 Mayo 评分（PMS），用于定义 IBD 的临床缓解，但可能无法代表真正的炎症程度，且内镜检查具有侵入性。非侵入性检测选项包括 C 反应蛋白（CRP）和粪便钙卫蛋白（FCP）。
本研究旨在评估非侵入性生物标志物与 PROs 的相关性，以及其他临床变量对其水平的影响。
我们回顾了来自前瞻性成人研究队列与 IBD（SPARC-IBD）的前瞻性队列研究的数据，该队列由来自 17 个三级转诊中心的 3000 多名患者组成。根据疾病类型分析人口统计学和临床变量，根据 PROs 评估疾病严重程度，并测量基线 CRP 和 FCP。为了进行比较分析，我们进行了 Fisher 确切检验和 Welch's t 检验，p<0.05 为有统计学意义。
纳入了 1547 名患者；63%患有 CD，56%为女性，平均病程为 13.6 年。CRP 和 FCP 与炎症性 CD 的症状严重程度相关。CRP 可用于区分 CD 不同疾病部位的症状，而 FCP 仅与克罗恩病结肠炎的症状严重程度相关。对于 UC，FCP 能够更好地区分远端 UC 的症状严重程度，而在广泛或全结肠炎中，它仅有助于将严重症状与其他症状严重程度类别区分开来。
PROs 与 CRP 和 FCP 相关；然而，疾病部位和表型会影响它们区分症状严重程度的能力。
