Evaluation of serum bilirubin, uric acid, albumin levels in patients with crohn's disease

Evaluation of serum bilirubin, uric acid, albumin levels in patients with Crohn's disease Oxidative stress and antioxidant deficiency play key roles in the pathogenesis of Crohn's disease (CH) -related gastrointestinal injury. Serum bilirubin, uric acid and albumin are nonenzymatic antioxidants that play a role in oxidative stress control. These biochemical parameters can be easily determined from blood samples at low cost and are among the routine tests in clinical practice. These serum parameters may be suitable biomarkers for the determination of antioxidant status in patients with CD. According to our best knowledge; until now, serum bilirubin, albumin and uric acid levels with the number of studies examining the relationship between CH are few and not previously reported such a study from Turkey. Our aim is to evaluate serum bilirubin, albumin and uric acid levels in Crohn's patients undergoing medical treatment, and to observe the changes in these parameters with disease activity and medical treatment. Our study was a single-center retrospective cohort study, of which 114 of 234 patients were Crohn's disease and 120 were healthy controls. 49% (n=56) of the Crohn's patients were male and 39% (n=47) of the healthy control group were male. The mean age of the Crohn's patients was 39.36 ± 12.26; the healthy control group was found to be 39,12 ± 13,63. While 71,1% (n=81) of the patients were in remission, 20,2% (n=23) had mild-moderate, and 8,8% (n=10) had moderate-severe disease activity. In our study, total bilirubin, direct bilirubin and albumin levels were found to be significantly lower in the Crohn's patient group compared to the health control group (p = 0,045; p = <0,01; p = <0,01). There was no significant difference between indirect bilirubin and uric acid values (p = 0,128; p = 0,481). There was no significant difference between the disease activity of the patients and the levels of total bilirubin, direct bilirubin, indirect bilirubin, and uric acid p=0,300; p=0,378; p=0,340; p= 0,173). While the disease activity was negatively correlated with albumin, total bilirubin, and induced bilirubin levels; the CRP level was found to be positively correlated (p = <0,01 r = -0,510; p = 0,034 r = -0,201; p = 0,021 r = -0,219; p: <0,01 r= 0,503). While there was a significant difference between CRP and albumin levels in remission and active Crohn's group (p = <0,01; p = <0,01 ); there was no significant difference between total bilirubin, direct bilirubin, indirect bilirubin and uric acid levels (p = 0,170; p = 0,280; p = 0,233; p = 0,478). While there was a significant difference in total bilirubin, direct bilirubin, indirect bilirubin, albumin levels between healthy control group and active Crohn's patients (p = 0,009; p = 0,001; p = 0,037; p = <0,01); there was no significant difference with uric acid level (p = 0,992). While a significant difference was found between the healthy control group and Crohn's patients in remission (p = 0,005); there was no difference between total bilirubin, indirect bilirubin, albumin, and uric acid levels (p = 0,263; p = 0,440; p = 0,112; p = 0,365). There was no difference in serum total bilirubin, direct bilirubin, indirect bilirubin, uric acid, albumin levels between the patients who received azathioprine treatment and the patients who received other treatments (p = 0,887; p = 0,832; p = 0,657; p = 0,617; p = 0,317) . The lower serum total bilirubin, direct bilirubin and albumin levels, which are endogenous antioxidants in the Crohn's patient group, may be due to the decrease in their levels as a result of excessive consumption and / or destruction of endogenous antioxidant molecules in case of inflammation. Antioxidant capacity reaches levels similar to the healthy population in patients who achieve remission with medical treatment. Serum bilirubin, uric acid and albumin are endogenous antioxidants, and their changes in blood in the case of chronic inflammation show us the role of oxidative damage in the pathogenesis of Crohn's disease. Keywords: albumin, bilirubin, Crohn's disease, oxidative stress, uric acid