Can Inflammatory Indexes Predict the Severity of Mucosal Inflammation in Ulcerative Colitis?

Aim: Inflammatory indexes can relate to disease activity in ulcerative colitis (UC). This study aimed to evaluate whether the inflammatory indexes of neutrophil-lymphocyte ratio (NLR), C-reactive protein (CRP)-albumin ratio (CAR), CRP-lymphocyte ratio (CLR), and systemic immune-inflammation index (SIII) might predict the severity of mucosal inflammation in UC. Material and Methods: This retrospective case-control study included 184 UC patients and 101 healthy controls. The Mayo clinical score and Mayo endoscopic score were used for the clinical and endoscopic features of UC. Truelove and Richards’s method for the severity of mucosal inflammation determined the histological activity index (HAI). Results: The inflammatory index values, were higher in UC patients compared to the control group (p=0.007 for NLR, and p<0.001 for the others). The patients having endoscopic, clinic, and histologically active disease had higher inflammatory index values than those in remission (p<0.001 for all). UC patients with extensive disease had higher inflammatory index values than the patients who had limited disease (p<0.001 for all). The HAI values were positively correlated to all inflammatory indexes, and the correlation was the strongest between the HAI and CLR (rho=0.737, p<0.001). Regarding HAI, the diagnostic accuracy of all inflammatory indexes for detecting the clinically active disease was statistically significant, and there was no significant difference between them in terms of diagnostic accuracy. Conclusion: The inflammatory indexes of NLR, CAR, CLR, and SII might predict the severity of histological inflammation in UC.