Omer Nazdar, Ibrahim Shereen, Ramadhan Ali A
Department of Medical Physiology and Pharmacology, University of Duhok, Duhok, IRQ.
Department of Medicine, University of Duhok, Duhok, IRQ.
Cureus. 2025 May 14;17(5):e84073. doi: 10.7759/cureus.84073. eCollection 2025 May.
Background The incidence of inflammatory bowel diseases (IBD) has increased over the last century. Despite the unclear etiology of IBD, significant advancements have been made in recent years to understand the development of this disease. Objectives The aim of this study was to examine the diagnostic significance of several inflammatory biomarkers and their associations with clinical and endoscopic disease activity in patients with IBD. Methods This case-control study involved 68 patients, 34 with Crohn's disease (CD) and 34 with ulcerative colitis (UC), with IBD confirmed by endoscopy and histopathology, and 52 healthy subjects as a control group. A pre-designed questionnaire was completed for each subject. Stool samples were taken for fecal calprotectin (FC) measurement by enzyme-linked immunosorbent assay (ELISA), and a blood sample was obtained for complete blood and differential counts using a hematology autoanalyzer, erythrocyte sedimentation rate (ESR), serum C-reactive protein (CRP) by Cobas (Roche Diagnostics, Basel, Switzerland), and measurements of interleukins (IL-6, IL-17A, IL-8, and IL-1β) by ELISA. Comparisons of parameters were considered statistically significant at the P < 0.05 interval. Results The mean levels of ESR, CRP, FC, all measured ILs, neutrophil number and percentage (%), neutrophil-lymphocyte ratio (NLR), and platelet number were statistically significantly higher in patients with IBD compared to the control group. However, lymphocyte%, lymphocyte-mid-size leukocytes ratio (LMR), hemoglobin, mean corpuscular hemoglobin (MCH), hematocrit, and red cell distribution width (RDW) were significantly lower in patients with IBD compared to controls. Receiver operating characteristic (ROC) curve analyses showed that FC, IL-8, and ESR, respectively, have the highest area under the curve (AUC) and were of the highest validity to differentiate between patients with IBD and healthy subjects, followed by CRP and IL-1β. Conclusion All the studied ILs were increased in patients with IBD; their increases were not different between UC and CD patients. FC, IL-8, and ESR were of the highest validity for the diagnosis of IBD. Findings collectively highlight the validity of the measured parameters as potential biomarkers in IBD.
背景：在过去的一个世纪里，炎症性肠病（IBD）的发病率有所上升。尽管IBD的病因尚不清楚，但近年来在了解这种疾病的发展方面取得了重大进展。 目的：本研究的目的是探讨几种炎症生物标志物的诊断意义及其与IBD患者临床和内镜疾病活动的关系。 方法：本病例对照研究纳入68例患者，其中34例为克罗恩病（CD）患者，34例为溃疡性结肠炎（UC）患者，均经内镜检查和组织病理学确诊为IBD，另选52名健康受试者作为对照组。为每位受试者填写一份预先设计的问卷。采集粪便样本，采用酶联免疫吸附测定（ELISA）法检测粪便钙卫蛋白（FC）；采集血液样本，使用血液学自动分析仪进行全血细胞计数和分类计数，检测红细胞沉降率（ESR）、采用Cobas（瑞士巴塞尔罗氏诊断公司）检测血清C反应蛋白（CRP），并采用ELISA法检测白细胞介素（IL-6、IL-17A、IL-8和IL-1β）。当P<0.05时，参数比较具有统计学意义。 结果：与对照组相比，IBD患者的ESR、CRP、FC、所有检测的白细胞介素、中性粒细胞数量和百分比（%）、中性粒细胞与淋巴细胞比值（NLR）以及血小板数量的平均水平在统计学上显著更高。然而，与对照组相比，IBD患者的淋巴细胞%、淋巴细胞与中等大小白细胞比值（LMR）、血红蛋白、平均红细胞血红蛋白含量（MCH）、血细胞比容和红细胞分布宽度（RDW）显著更低。受试者工作特征（ROC）曲线分析表明，FC、IL-8和ESR的曲线下面积（AUC）分别最高，在区分IBD患者和健康受试者方面具有最高的有效性，其次是CRP和IL-1β。 结论：所有研究的白细胞介素在IBD患者中均升高；UC和CD患者之间的升高情况没有差异。FC、IL-8和ESR对IBD的诊断有效性最高。这些发现共同突出了所测参数作为IBD潜在生物标志物的有效性。
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