Jo Kijae, Kim Kwang Woo, Lee Hyun Jung, Im Jong Pil, Kim Joo Sung, Koh Seong-Joon
Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea.
Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea.
Intest Res. 2024 Oct;22(4):453-463. doi: 10.5217/ir.2024.00044. Epub 2024 May 22.
BACKGROUND/AIMS: The prevalence and incidence of ulcerative colitis (UC) in Korea is increasing. Each patient has a different disease course and treatment response. Recently, with the development of biologic agents, histological remission has become a treatment goal. In this study, we aimed to identify the predictors of histological remission after first-line biologic agent treatment in patients with biologic agent-naïve UC.
We retrospectively analyzed the medical records of 92 patients who had been diagnosed with UC and treated with first-line biologic agent treatment at our center, between 2015 and 2022. The clinical characteristics, laboratory test results, and endoscopic and biopsy findings were analyzed. Histological remission was defined as the absence of cryptitis, crypt abscesses, and inflammatory cells on histology. Univariate and multivariate logistic regression analyses were performed to identify the predictors of histological remission after first-line treatment.
Of the total 92 patients, 25 (27.2%) achieved histological remission. Each cohort had a varied body mass index (BMI) distribution, with a statistically significant overweight ratio, as defined by the Asian-Pacific BMI category of 23-25 kg/m2, of 48.0% in the histological remission cohort (P= 0.026). A causal correlation between the overweight category and histological remission was confirmed (odds ratio, 3.883; 95% confidence interval, 1.141-13.212; P= 0.030).
We confirmed that the overweight category was a predictor of histological remission after first-line treatment with a biological agent. However, as BMI does not account for skeletal muscle mass, future studies are required to confirm the correlation between skeletal muscle mass and histological remission.
背景/目的：韩国溃疡性结肠炎（UC）的患病率和发病率正在上升。每位患者的病程和治疗反应各不相同。近年来，随着生物制剂的发展，组织学缓解已成为治疗目标。在本研究中，我们旨在确定初治生物制剂的UC患者接受一线生物制剂治疗后组织学缓解的预测因素。
我们回顾性分析了2015年至2022年间在本中心被诊断为UC并接受一线生物制剂治疗的92例患者的病历。分析了临床特征、实验室检查结果以及内镜和活检结果。组织学缓解定义为组织学上无隐窝炎、隐窝脓肿和炎症细胞。进行单因素和多因素逻辑回归分析以确定一线治疗后组织学缓解的预测因素。
在总共92例患者中，25例（27.2%）实现了组织学缓解。每个队列的体重指数（BMI）分布各不相同，按照亚太地区BMI分类23 - 25 kg/m²定义的超重比例在组织学缓解队列中具有统计学意义，为48.0%（P = 0.026）。超重类别与组织学缓解之间的因果关系得到证实（优势比，3.883；95%置信区间，1.141 - 13.212；P = 0.030）。
我们证实超重类别是生物制剂一线治疗后组织学缓解的预测因素。然而，由于BMI未考虑骨骼肌质量，未来需要进一步研究以证实骨骼肌质量与组织学缓解之间的相关性。
