Hemoglobin-to-Inflammation Marker Ratios Reflect Endoscopic Activity in Inflammatory Bowel Disease

Area of Science:

• Gastroenterology
• Clinical Diagnostics
• Biomarker Research

Background:

• Inflammatory bowel disease (IBD), encompassing ulcerative colitis (UC) and Crohn's disease (CD), requires accurate assessment of endoscopic activity for effective management.
• Current monitoring often relies on invasive endoscopic procedures or less specific clinical markers.

Purpose of the Study:

• To evaluate the diagnostic utility of hemoglobin-to-inflammation marker ratios, specifically Hb/WBC, Hb/Neu, Hb/PLT, and Hb/CRP, in assessing endoscopic disease activity in IBD patients.
• To compare the performance of these ratios against established endoscopic scoring systems and individual laboratory markers.

Main Methods:

• A retrospective, single-center cross-sectional study included 270 IBD patients (175 UC, 95 CD) meeting specific inclusion/exclusion criteria.
• Data collected included clinical information, laboratory markers (hemoglobin, WBC, neutrophils, platelets, CRP), and endoscopic scores (Mayo, UCEIS, SES-CD).
• Statistical analyses involved ROC curve analysis, correlation, and multivariate logistic regression to determine diagnostic performance and independent factors.

Main Results:

• The hemoglobin-to-CRP (Hb/CRP) ratio demonstrated superior performance in distinguishing active IBD from remission across UC and CD.
• Hb/CRP showed high diagnostic accuracy (AUCs ranging from 0.839 to 0.924) and outperformed hemoglobin alone, with comparable accuracy to CRP alone.
• Hb/CRP was identified as an independent protective factor for disease remission, with sensitivity analyses confirming its robustness, especially in UC patients.

Conclusions:

• Hemoglobin-to-inflammation ratios, particularly Hb/CRP, exhibit promising diagnostic value for assessing endoscopic activity in IBD.
• Hb/CRP may serve as a valuable, non-invasive adjunctive tool for monitoring IBD activity, complementing existing clinical assessments.
• Further prospective studies are needed to validate these findings and compare Hb/CRP directly with fecal calprotectin (FC).