Clinical Significance Of DUBLIN Score And Bilirubin In Evaluating The Severity Of Ulcerative Colitis

Objective We evaluated the efficacy of degree of ulcerative colitis burden of luminal inflammation(DUBLIN)score in predicting ulcerative colitis(UC)and even the severity of disease.Methods This case-control study enrolled 181 patients with active UC who were hospitalized in the Affiliated Huaian No.1 People’s Hospital of Nanjing Medical University from January 2017 to December 2019 as the case group and 187 healthy controls.Patients were classified as mild-to-moderate UC and severe UC by the modified Truelove and Witts criteria.White blood cell count(WBC),hemoglobin(Hb),platelet count(PLT),neutrophil count(N),lymphocyte count(L),monocyte count(M),total bilirubin(TBil),albumin(Alb),erythrocyte sedimentation rate(ESR)and C-reactive protein(CRP)were compared between case group and control group.Spearman correlation analyses verified the relationship between DUBLIN score and Extent,Mayo endoscopic score(MES)and ulcerative colitis endoscopic index of severity(UCEIS).Receiver operator curve(ROC)analyses assessed the performance of DUBLIN score in discriminating CRP>5 mg/L and severe disease states.Results Elevated WBC,PLT and N counts and decreased L,TBil,Hb and Alb values significantly differed between case group and controls.DUBLIN score was positively correlated with WBC,PLT,N,M,ESR and CRP,but negatively correlated with Hb,TBil and Alb(P<0.05)in UC patients.DUBLIN score had a good correlation with Extent,MES and UCEIS(P<0.05).ROC analyses revealed that DUBLIN score was performed better at judging CRP > 5 mg/L and differentiating severe UC patients from mild-to-moderate UC than Extent,MES and UCEIS.Conclusion DUBLIN score correlated well with peripheral blood inflammatory indexes,which might be effective to identify the disease severity of UC.Objective Several serum parameters can be used to assess disease activity of ulcerative colitis(UC).However,the value of these parameters for predicting UC severity has not been studied in depth.We therefore sought to investigate the value of serum total bilirubin(TBil)as a predictor of UC severity and the degree of ulcerative colitis burden of luminal inflammation(DUBLIN).Methods A prospective study included 181 patients with active UC who were hospitalized in the Affiliated Huaian No.1 People’s Hospital of Nanjing Medical University from January 2017 to December 2019 as the case group and 187 healthy controls.Disease severity was assessed using the modified Truelove and Witts criteria.The serum levels of hemoglobin(Hb),TBil,albumin(Alb),erythrocyte sedimentation rate(ESR)and C-reactive protein(CRP)were compared in different severity groups,and the correlation between TBil and serological inflammatory biomarkers were performed.Logistic regression analysis was used to determine the UC,severe disease extent and high DUBLIN score(>4).Results UC patients had lower Hb,TBil and Alb levels than healthy participants(P<0.05),and the levels of Hb,Alb and TB were lower in severe UC patients than that in mild-to-moderate UC patients(P<0.05).TBil indicated positive correlation with Hb and Alb and negative correlation with CRP and ESR(P<0.05).In comparison with that of the highest quartile,low levels of TBil(≦12.05μmol/L)was associated with UC(P<0.05),and TBil level in the first quartile was associated with severe UC(OR: 3.15,P=0.034)and high DUBLIN(OR: 4.28,P=0.001).Conclusions Serum TBil level decreased in the UC patients than healthy controls,and low level of serum TBil was an effective predictor of the UC,severe disease states and high DUBLIN.