Abstract
AIM: Ulcerative colitis (UC) is an incurable disease represented by relapse and remission. Noninvasive biomarkers are required to predict disease activation. This study aimed to identify noninvasive biomarkers, such as the c-reactive protein-albumin (CRP/ALB) ratio, platelet-lymphocyte ratio (PLR), and neutrophil-lymphocyte ratio (NLR), that might forecast disease activation in UC. METHODS: This retrospective study included 443 participants: 192 patients with active UC, 166 in remission, and 85 healthy controls. Mayo Endoscopic Subscore was employed to assess endoscopic disease activity. Serum CRP, erythrocyte sedimentation rate (ESR), ALB levels, and complete blood count characteristics were documented. Three ratios of inflammation-related indicators were identified as CRP/ALB, PLR, and NLR. RESULTS: A positive correlation was found between ESR, CRP, neutrophil count, platelet count, levels of CRP/ALB, PLR, NLR, and endoscopic activity. The CRP/ALB ratio demonstrated more efficacy than the NLR and PLR in differentiating the UC patients from the controls (p = 0.007, p = 0.003, respectively) and the active group from the remission group (p < 0.001, p < 0.001, respectively). Regression analysis revealed that the CRP/ALB was significantly able to distinguish active UC from the remission group and the controls (p < 0.001, p < 0.001, respectively). CONCLUSION: The CRP/ALB ratio could be useful as an independent predictive biomarker for disease activity in UC.