Elevated serum sortilin reflects inflammatory burden and coagulation dysfunction in ulcerative colitis

Sortilin, a multifunctional receptor, is implicated in inflammatory signaling; however, its clinical significance in ulcerative colitis (UC) remains unclear. This study evaluated serum sortilin levels in patients with UC and their associations with disease activity, inflammation, and coagulation.

Serum sortilin, inflammatory cytokines (TNF-α, IL-1β, IL-6, IL-17A, and IL-10), and coagulation indices (fibrinogen and D-dimer) were measured in patients with UC and healthy controls. Patients were stratified according to disease activity and severity. Correlations between serum sortilin levels and clinical, biochemical, and inflammatory parameters were assessed. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic value of serum sortilin.

Serum sortilin levels were significantly higher in patients with UC than in healthy controls (p < 0.001) and were further elevated in active UC compared to those in remission (p < 0.001). Sortilin concentrations increased progressively with disease severity. Positive correlations were observed between serum sortilin and CRP (r = 0.522), TNF-α (r = 0.576), IL-1β (r = 0.442), IL-6 (r = 0.684), IL-17A (r = 0.492), fibrinogen (r = 0.267), D-dimer (r = 0.543), platelet count (r = 0.257), white blood cell count (r = 0.214), and Mayo score (r = 0.615) (all p < 0.05). In contrast, negative correlations were found with IL-10 (r = -0.609) and hemoglobin (r = -0.226; both p < 0.05), whereas no significant association was observed with albumin (p = 0.584). ROC analysis demonstrated high diagnostic accuracy for serum sortilin in distinguishing UC patients from controls [area under the curve (AUC) = 0.944; sensitivity, 83.2%; specificity, 93.8%] and in differentiating severe from mild UC (AUC = 0.968; sensitivity, 86.4%; specificity, 96.3%).

Elevated serum sortilin levels are closely associated with disease activity, inflammatory cytokines, and coagulation parameters in UC, suggesting that sortilin may serve as a novel biomarker reflecting both inflammatory and hypercoagulable states in UC pathogenesis.