Serum Globulin Is Associated with Endoscopic Findings and Mucosal Healing in Japanese Patients with Ulcerative Colitis

Digestive Diseases and Sciences (2021)Cite this article

Abstract

Background

Serum globulin is an inflammation marker. To date, no evidence regarding the association between serum globulin and disease activity in patients with ulcerative colitis has been reported.

Aims

We evaluated the association between serum globulin and endoscopic activity in patients with ulcerative colitis.

Methods

Serum globulin was divided into tertiles based on the distribution of study subjects (low globulin, ≤ 2.7 g/dl (reference); moderate globulin, 2.7–3.1 g/dl; and high globulin, > 3.1 g/dl). A single endoscopic specialist evaluated the endoscopic findings, and mucosal healing was based on Mayo endoscopic subscore.

Results

A total of 277 patients with ulcerative colitis were included in the study. Serum globulin was independently positively associated with diminished or absent vascular markings [moderate: adjusted odds ratio (OR) 3.70 (95% confidence interval, CI: 1.82–7.88) and high: adjusted OR 2.40 (95%CI: 1.20–4.94), p for trend = 0.005]. A similar positive association between globulin and erosion was found [high: adjusted OR 2.00 (95%CI: 1.05–3.86)]. Serum globulin was independently inversely associated with mucosal healing [moderate: adjusted OR 0.37 (95%CI: 0.18–0.73) and high: adjusted OR 0.31 (95%CI: 0.14–0.64), p for trend = 0.001] and adjusted partial mucosal healing [moderate: OR 0.51 (95%CI: 0.26–0.98), p for trend = 0.048]. The inverse association between globulin and mucosal healing was significant in the low but not the high C-reactive protein group.

Conclusions

In patients with ulcerative colitis, serum globulin was significantly positively associated with endoscopic activity, and was significantly inversely associated with mucosal healing, especially in the low C-reactive protein group.

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Acknowledgments

The authors would like to thank Shogo Kitahata, Yu Hashimoto, Masakazu Hanayama, Kazuhiro Tange, Kanako Konishi, Tomoe Kawamura, Hideomi Tomida, Yasunori Yamamoto, Tomo Kogama, Masumi Hino, and Keiko Kikuchi for their support.

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Affiliations

  1. Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, Japan

    Kana Shiraishi & Yoichi Hiasa

  2. Health Services Center, Ehime University, Matsuyama, Bunkyo, Ehime, Japan

    Shinya Furukawa

  3. Department of Internal Medicine, Saiseikai Matsuyama Hospital, Yamanishi, Matsuyama, Ehime, Japan

    Sen Yagi & Hidehiro Murakami

  4. Department of Gastroenterology, Ehime Prefectural Central Hospital, Kasuga, Matsuyama, Ehime, Japan

    Kenichirou Mori & Tomoyuki Ninomiya

  5. Department of Internal Medicine, Saiseikai Imabari Hospital, Kita, Imabari, Ehime, Japan

    Keitarou Kawasaki

  6. Department of Gastroenterology, Matsuyama Shimin Hospital, Ote, Matsuyama, Ehime, Japan

    Yuji Mizukami

  7. Department of Gastroenterology, Sumitomo Besshi Hospital, Oji, Niihama, Ehime, Japan

    Seiyuu Suzuki

  8. Uraoka Gastrointestinal Clinic, Ishite, Matsuyama, Ehime, Japan

    Masayoshi Uraoka

  9. Department of Gastroenterology, Ehime Prefectural Niihama Hospital, Hongo, Niihama, Ehime, Japan

    Naozumi Shibata

  10. Department of Gastroenterology, Shinsenkai Matsuyama Madonna Hospital, Kiyo, Matsuyama, Ehime, Japan

    Sanae Nakamura

  11. Department of Internal Medicine, Shiritsu Oozu Hospital, Nishioozu, Oozu, Ehime, Japan

    Satoshi Imamine

  12. Ohashi Clinic Participate in Gastro-Enterology and Ano-Proctology, Funaki, Niihama, Ehime, Japan

    Katsuhisa Ohashi

  13. Department of Internal Medicine, Saiseikai Saijo Hospital, Tsuitachi, Saijo, Ehime, Japan

    Masamoto Torisu

  14. Yano Clinic, Higashinagato, Matsuyama, Ehime, Japan

    Makoto Yano

  15. Department of Gastroenterology, Shikoku Cancer Center, Minamiumenomoto, Matsuyama, Ehime, Japan

    Aki Hasebe

  16. Department of Gastroenterology, Saijo City Shuso Hospital, Nyugawa, Saijo, Ehime, Japan

    Harumi Yano

  17. Department of Gastroenterology, Murakamikinen Hospital, Oomachi, Saijo, Ehime, Japan

    Masato Murakami

  18. Department of Inflammatory Bowel Diseases and Therapeutics, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, Japan

    Eiji Takeshita

  19. Endoscopy Center, Ehime University Hospital, Shitsukawa, Toon, Ehime, Japan

    Yoshio Ikeda

Authors
  1. Kana Shiraishi
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  2. Shinya Furukawa
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  3. Sen Yagi
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  4. Kenichirou Mori
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  5. Tomoyuki Ninomiya
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  6. Keitarou Kawasaki
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  7. Yuji Mizukami
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  8. Seiyuu Suzuki
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  9. Masayoshi Uraoka
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  10. Naozumi Shibata
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  11. Sanae Nakamura
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  12. Satoshi Imamine
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  13. Hidehiro Murakami
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  14. Katsuhisa Ohashi
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  15. Masamoto Torisu
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  16. Makoto Yano
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  17. Aki Hasebe
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  18. Harumi Yano
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  19. Masato Murakami
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  20. Eiji Takeshita
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  21. Yoshio Ikeda
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  22. Yoichi Hiasa
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Corresponding author

Correspondence to Shinya Furukawa.

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Shiraishi, K., Furukawa, S., Yagi, S. et al. Serum Globulin Is Associated with Endoscopic Findings and Mucosal Healing in Japanese Patients with Ulcerative Colitis. Dig Dis Sci (2021). https://doi.org/10.1007/s10620-021-06834-5

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Keywords

  • Globulins
  • Ulcerative colitis
  • Endoscopy
  • Biomarkers