RESEARCH ARTICLE


Corrected ESR/Albumin Ratio as a Simple, Practical Marker Predicts the Severity in Egyptian Ulcerative Colitis Patients



Shimaa El Sharawy1, Hemat El-Horany2, Ibrahim Amer3, *
1 Department of Tropical Medicine and Infectious Diseases, Faculty of Medicine, Tanta University, Tanta, Egypt
2 Department of Medical Biochemistry, Faculty of Medicine, Tanta University, Tanta, Egypt
3 Department of Hepatology, Gastroenterology and Infectious Diseases, Faculty of Medicine, Kafr El Sheikh University, Kafr Elsheikh, Egypt


© 2021 El Sharawy et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Hepatology, Gastroenterology and Infectious Diseases, Faculty of Medicine, Kafr El Sheikh University, Tanta, El Shober Street, Egypt; Tel: 00201063307637; E-mails: hema.amer30@gmail.com, ebrahiem_.amier@med.kfs.edu.eg


Abstract

Background:

Serum biomarkers are commonly used for diagnosing and monitoring the disease activity of Ulcerative Colitis (UC) patients. However, their role in predicting disease severity among Egyptian patients is unknown.

Objectives:

The aim of this study was to correlate these biomarkers with clinical, endoscopic and histologic severity.

Methods:

This is a cross-sectional survey where 55 patients with UC were included to measure corrected Erythrocyte Sedimentation Rate (ESR), hematocrit (Hct), corrected ESR/albumin ratio and albumin, as well as colonoscopy and biopsy. Sensitivity and specificity, positive and negative predictive values were correlated with clinical, endoscopic, histologic severity.

Results:

The mean age of patients was 33 ± 8.4 years. In total, 27 (49.1%) were males and 28 (50.9%) were females. Area Under the Curve (AUC) values for the diagnosis of severe clinical disease were 0.947, 0.932, 0.727 and 0.685 for corrected ESR/albumin ratio, corrected ESR, Hct and albumin, respectively. Cut-off value to determine endoscopic severity for Hct was 34 (sensitivity: 88.89%, specificity: 83.78%, PPV: 72.7%, NPV: 93.9%, AUC: 0.963, p<0.001).

Conclusion:

Corrected ESR/albumin ratio was the best predictor of severe clinical activity of UC disease. Hct may be a marker of endoscopic and histological severity due to its high sensitivity and specificity as a diagnostic test.

Keywords: Egypt, Ulcerative Colitis, Biomarkers, Prediction, Endoscopy, Disease activity.