Efficacy of Serum Total Bilirubin in Predicting the Severity of Ulcerative Colitis: A Cross-Sectional Study.

ABSTRACT

OBJECTIVE: Several serum parameters can be used to assess ulcerative colitis (UC) disease activity. However, the value of these parameters for predicting UC severity has not been studied in depth. Therefore, we sought to investigate the value of serum total bilirubin (TB) as a predictor of UC severity. MATERIALS AND METHODS: This cross-sectional study included 448 UC patients and 308 healthy participants. Data regarding the serum levels of TB, hemoglobin (Hb), albumin (Alb), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) were collected. UC severity was evaluated according to the Truelove and Witts criteria. Wilcoxon rank sum tests were used to compare data between groups, while Spearman correlation analyses between TB and the levels of Hb, Alb, ESR and CRP were performed. Logistic regression analyses were used to determine the odds ratios (ORs) for severe UC in UC patients. RESULTS: UC patients had lower Hb, Alb, and TB levels than healthy participants (p<0.001). The Hb, Alb, and TB levels were lower in severe UC patients than in mild-to-moderate UC patients (p<0.001). TB was positively correlated with Hb and Alb, but negatively correlated with ESR and CRP (p<0.05). Logistic regression analysis revealed that the ORs for severe UC were 2.35 and 2.04 at TB concentrations of ≤8.00 µmol/L and 8.01-10.90 µmol/L, respectively (p<0.05). CONCLUSIONS: Serum TB level is an effective predictor of the severity of UC.