Serum soluble endoglin is associated with clinical and endoscopic disease activity in ulcerative colitis

Endothelial dysfunction is implicated in ulcerative colitis (UC), but the value of soluble endoglin (sENG) for assessing disease activity remains unclear. We investigated associations between serum sENG and clinical and endoscopic activity in UC. This prospective, single-center case-control study enrolled 105 patients with UC and 68 healthy controls. Serum sENG was measured by enzyme-linked immunosorbent assay; clinical and endoscopic activity were defined by partial Mayo scores ≥3 and Mayo endoscopic subscores ≥2, respectively. Receiver operating characteristic analysis and multivariable logistic regression evaluated discriminatory performance and adjusted associations. Serum sENG was higher in patients with UC than in controls (median, 6.94 vs. 3.40 ng/mL; p < 0.001) and correlated with clinical and endoscopic scores (Spearman's correlation coefficients, 0.596 and 0.625, respectively; both p < 0.0001). Areas under the curve were 0.786 for distinguishing UC from controls, 0.765 for clinical activity, and 0.808 for endoscopic activity. Higher sENG remained independently associated with clinically active disease (adjusted odds ratio, 1.324; 95% confidence interval, 1.132-1.600; p = 0.001). Positive correlations were also observed with interleukin-6, tumor necrosis factor-α, interferon-γ, and interleukin-17A (all p < 0.001). Serum sENG shows potential as a noninvasive biomarker of UC activity, but its clinical utility requires external validation and comparison with established biomarkers.