![]() Any information that could lead to patient identity was eliminated, and all data included in this research were anonymized thus, the need for informed consent has been waived. ![]() This research protocol was approved by the Medical Ethics Committee of Wenzhou Medical University’s First Affiliated Hospital, Wenzhou, China, and was conducted following the Declaration of Helsinki. However, the correlation between serum AGR and IBD has not been established.Ĭonsidering the vital role of inflammation in IBD and the strong association between inflammatory responses and AGR, we speculated that serum AGR is closely related to the development and severity of IBD, and serum AGR might hold potential for distinguishing IBD from other GI symptoms and evaluating disease activity. 14, 24 The decreased albumin and increased globulin will substantially reduce AGR (calculated as albumin/globulin), suggesting its potential predictive value in inflammatory disease (such as IBD). 25 Current research has pointed out that globulin was positively associated with the severity of chronic inflammation 26 and increased in the progressive IBD. 24 Globulin, another abundant serum protein, plays an essential part in immunity and inflammation. 21, 22 As the main protein in human serum, albumin reflects nutritional status and acute-phase response to inflammation, 23 and its levels decrease after the inflammatory stimulus. AGR was negatively associated with chronic inflammation. 19, 20 In the last few years, several studies have demonstrated that serum AGR is a reliable indicator of poor prognosis in inflammatory disease and malignancy. 17, 18Īs mentioned previously, one of the critical characteristics of IBD is the deficit in the resolution of intestinal inflammation with extraintestinal involvement. However, its prediction value in UC and postoperative recurrence of CD was limited. 9 Besides, CRP, as a non-specific reactant, was reported to discriminate IBD from IBS accurately. 15 Whereas, the elevated levels of FC were not observed in CD patients even with large ulcers 16 and were not a good predictor for IBD activity. 12–14 FC and CRP have been widely studied and play a possible role in discriminating IBD from irritable bowel syndrome (IBS), evaluating disease activity, monitoring medication response, and so on. Currently, various biomarkers have been reported, including fecal calprotectin (FC), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), white blood cell (WBC) count, and so on. 11 Thus, developing a non-invasive method that is more convenient, tolerable, reliable, economical, and faster for accurately diagnosing IBD and monitoring IBD activity is of great importance. 10 However, endoscopy tends to be least tolerable due to its considerable cost, inconvenience, and invasive risk, especially when routinely re-evaluated. 9 The cross-sectional imaging offers complementary information of small bowel, which the endoscope can hardly reach. 8 Endoscopy with pathological examination is the gold standard for diagnosing IBD and evaluating disease activity. 6 In contrast, delays in referral and diagnosis seem prevalent in IBD. 4–7 Moreover, IBD has a notable impact on patients’ physical and psychological health, making it critical to diagnose and treat as quickly as possible. 2, 3 IBD has become a global public health problem that generates significantly higher morbidity and an enormous burden for health care systems. It is thought to be due to the interaction of commensal bacteria (or their products), susceptibility genes, environmental factors (such as diet), and immune deficiencies. 1 The pathogenesis of IBD is undefined, complex, and not yet fully understood. Inflammatory bowel disease (IBD), which consists of ulcerative colitis (UC) and Crohn’s disease (CD), is a chronically relapsing inflammatory intestinal disorder with an incidence continuously ascending in recent years, especially in developing countries.
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