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Fecal calprotectin level in microscopic colitis: a systematic review and meta-analysis
Busara Songtanin1, Chanaka Kahathuduwa1, Kenneth Nugent1
1Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas, USA.
Background:
There are no specific biomarkers for microscopic colitis (MC), and the diagnosis depends on histopathological tissue obtained during colonoscopy. Studies on the role of fecal calprotectin (FCP) in MC are limited. A literature search of PubMed, Embase, and Scopus was conducted from each database's inception through September 2022.
Methods:
A DerSimonian-Liard random-effects meta-analysis was performed to examine the standardized mean difference (SMD) in FCP levels between patients with MC and control patients with chronic diarrhea.
Results:
Six studies with 96 active MC patients and 200 controls were included in the meta-analysis. Random effects meta-analysis revealed that FCP was significantly and moderately elevated in patients with MC compared to the control group (SMD = 0.6 [95% CI 0.3, 1.0], P = 0.001). Imputing one effect size confirmed the observation that FCP is significantly higher in patients with MC than control subjects with chronic diarrhea (SMD = 0.5 [95% CI 0.2, 0.9], P = 0.004). Study heterogeneity between the SMDs was not significant (I2 = 41%, P = 0.1).
Conclusion:
These results indicate that FCP levels in patients with chronic diarrhea can help identify patients with MC. More studies with serial measurements of FCP would provide a better understanding of its utility in MC.
Insights
Fecal calprotectin (FCP) is moderately elevated in patients with microscopic colitis (MC). This finding suggests FCP may aid in identifying MC in patients with chronic diarrhea.
Area of Science:
- Gastroenterology
- Clinical Diagnostics
- Inflammatory Bowel Disease Research
Background:
- Microscopic colitis (MC) lacks specific biomarkers, necessitating diagnosis via colonoscopy and histopathology.
- Limited research exists on the role of fecal calprotectin (FCP) in diagnosing MC.
Purpose of the Study:
- To evaluate the utility of fecal calprotectin (FCP) as a potential biomarker for microscopic colitis (MC).
- To compare FCP levels in MC patients versus individuals with chronic diarrhea.
Main Methods:
- A systematic literature search was conducted on PubMed, Embase, and Scopus up to September 2022.
- A random-effects meta-analysis (DerSimonian-Liard) was employed to compare FCP levels between MC patients and controls.
Main Results:
- The meta-analysis included six studies with 96 MC patients and 200 controls.
- Fecal calprotectin (FCP) was found to be significantly and moderately elevated in MC patients compared to controls (SMD = 0.6).
- Heterogeneity among studies was not statistically significant (I² = 41%).
Conclusions:
- Elevated FCP levels in patients with chronic diarrhea may help identify those with microscopic colitis (MC).
- Further research involving serial FCP measurements is recommended to fully understand its diagnostic utility in MC.
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