The role of CRP / Albumin Ratio, Albumin / Platelet Ratio and Systemic Immune Inflammation Index in determining disease activation in patients with ulcerative colitis

The Role of CRP / Albumin Ratio, Albumin / Platelet Ratio and Systemic Immune Inflammation Index in Determining Disease Activation in Patients with Ulcerative Colitis Objective: The aim of our study was to retrospectively investigate the role of CRP/albumin ratio, albumin/platelet ratio and systemic immune inflammation index in determining disease activation in patients with ulcerative colitis. Materials and Methods: The study was performed as a single-center retrospective review of the files of 130 patients with ulcerative colitis who were followed up in the Internal Medicine Clinics and Gastroenterology Clinic of Süleyman Demirel University Research and Application Hospital. Patients between the ages of 18 and 80 who were diagnosed with ulcerative colitis and admitted to our hospital between January 2015 and December 2022 and were in the routine diagnosis and treatment process were included in the study, while patients with a history of malignancy, rheumatologic disease, known hematologic disease, liver failure, chronic renal failure, autoimmune disease were excluded from the study. In the study, colonoscopic findings related to disease severity, site of involvement in the colon, CRP (C-reactive protein), erythrocyte sedimentation rate (ESR), leukocyte count, neutrophil count, lymphocyte count, neutrophil to lymphocyte ratio (NLR), platelet count, Platelet/lymphocyte ratio (PLR), hemoglobin (hb) level, albumin level, fecal calprotectin level, CRP/albumin ratio (CAR), albumin/platelet ratio (APR) and SIII (systemic immune-inflammation index) levels were evaluated. Patients were divided into two different groups as remission and active disease using the colonoscopic activity score (Rachmilewitz Endoscopic Activity Index) and the changes in CAR, APR and SIII values with disease activity were compared between the groups. Data presentation was made using numbers, percentages, mean, standard deviation, minimum-maximum values, tables and graphs. The collected data were analyzed with descriptive statistics, Independent Sample t-Test, Mann-Whitney U Test, Chi-square Test, Kruskal Wallis Test, Kolmogorov-Smirnov Test, ROC Analysis and Pearson Correlation Tests in SPSS 22 package program. P significance level was accepted as p˂0.05. Findings: Of the 130 patients with ulcerative colitis, 57.7% (n=75) were male and 42.3% (n=55) were female. The mean age of the patients was 45.9±16.9 years. According to the endoscopic activity index, 55.4% (n=72) of the patients were in active disease and 44.6% (n=58) were in remission. A positive correlation was found between CRP, ESR, NLR, FC and disease activation in UC patients. There was no correlation between PLR and disease activity. There was a positive correlation between SIII and CAR and disease activity and a negative correlation between APR and disease activity. In addition, CAR and APR values were correlated with the extent of involvement. It was observed that CAR value was high and APR value was low in patients with widespread involvement. No correlation was found between SIII values and the prevalence of involvement. It was observed that NLR, PLR, CRP, ESR, and CAR levels increased and APR levels decreased as SIII levels increased. As SlII levels increased, FC levels also increased. However, this relationship was low and not statistically significant. As CAR levels increased, NLR, PLR, CRP, ESR laboratory values increased, while hemoglobin, albumin and APR values decreased. As APR levels increased, hemoglobin, albumin laboratory values increased; leukocyte, neutrophil, lymphocyte, platelet, PLR, CRP and ESR values decreased. These relationships were statistically significant. There was no statistically significant relationship between APR levels and NLR and FC values. Conclusion: The levels of inflammatory markers such as CRP/albumin, albumin/platelet ratios and systemic immune inflammation index are helpful in predicting the clinical, laboratory and endoscopic activity of the disease in patients with ulcerative colitis. Analysis of these markers may guide follow-up and treatment. Prospective and more comprehensive studies on the subject will provide information to the literature.