Evaluation of the relationship of systemic immune-inflammation and systemic inflammatory response indexes with nutritional status in adult individuals diagnosed with ulcerative colitis

Ulcerative colitis (UC) is an inflammatory bowel disease that primarily affects the colon and rectum mucosa, characterized by diarrhea containing mucus and blood, rectal bleeding, abdominal pain, anorexia, weight loss and increased body temperature. The aim of the study was to evaluate the relationship between systemic immune-inflammation and systemic inflammatory response indices and nutritional status in active and remission ulcerative colitis patients and healthy individuals. A case-control study was conducted on 96 individuals aged between 18 and 65 years, including active (n: 32) and remission (n: 32) UC patients and healthy individuals without any inflammatory disease (n: 32) who applied to the gastroenterology policlinic of SANKO University Training and Research Hospital. Within the scope of the study, demographic characteristics, nutritional habits and biochemical parameters of the patients were obtained and the Hospital anxiety depression scale (HADS) was applied. Mayo score and Rachmilewitz index were used to measure clinical colitis activity. Participants consisted of 46 male and 50 female patients, and the distribution of the groups was as follows: 56.3% male and 43.7% female in the active group, 46.9% male and 53.1% female in the remission group, 40.6% male and 59.4% female in the control group. The mean age of the groups was 34.94±14.17 years in the active group, 36.84±16.64 years in the remission group, and 40.81±11.57 years in the control group, respectively. Mainly C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), leukocyte count, neutrophil count, lymphocyte count, neutrophil/lymphocyte ratio (NLR), platelet count, platelet/lymphocyte ratio (PLR), hemoglobin (Hb) level, systemic immune-inflammation index (SII), systemic inflammation response index (SIRI) level and some biochemical parameters were evaluated. The mean BMI value of the individuals participating in the study was determined as 22.44±2.92 kg/m2 in the active group, 23.53±2.91 kg/m2 in the remission group and 23.49±3.89 kg/m2 in the control group (p>0.05). Daily energy intake was determined as 1248.03±384.14 kcal/day in the active group, 1251.41±278.69 kcal/day in the remission group, and 1315.6±296.16 kcal/day in the control group (p>0.05). Protein intake of individuals was determined as 0.78±0.33 g/kg/day in the active group, 0.78±0.28 g /kg/day in the remission group, and 0.81±0.23 g/kg/day in the control group (p>0.05). It was concluded that the intake of fat, vitamin K, vitamin B12, and monounsaturated fatty acids in the control group was higher than in the active group, the saturated fatty acid intake of individuals in the active group was lower than in the other groups, and the cholesterol levels of individuals in the remission group were higher than in the active group (p<0.05). It was determined that the Urea and ALT values of the individuals in the control group were higher than those in the active group, and the PDWr and MPV values of the individuals in the active group were lower than those in the other groups. (p<0.05). Other laboratory results showed no statistically significant difference between the groups (p>0.05). Consequently, it was demonstrated that despite being in the active, remission, and control groups, the study participants' food intake was similar. Inflammatory markers as NLR, PLR, SII, and SIRI are useful in predicting the clinical, laboratory, and endoscopic activity of UC, in this study there was not any relationship between the severity of the disease and the levels of these markers in ulcerative colitis groups. Keywords: Ulcerative colitis; Systemic immüne-inflammation; Systemic inflammatory response index; Hospital anxiety depression; Nutritional status