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. 2017 Dec 7;23(45):8008-8016.
doi: 10.3748/wjg.v23.i45.8008.

Albumin as a prognostic marker for ulcerative colitis

Nabeel Khan  1 , Dhruvan Patel  2 , Yash Shah  3 , Chinmay Trivedi  4 , Yu-Xiao Yang  1
Affiliations

Albumin as a prognostic marker for ulcerative colitis

Nabeel Khan et al. World J Gastroenterol. .

Abstract

Aim: To evaluate the role of albumin at the time of ulcerative colitis (UC) diagnosis in predicting the clinical course of disease.

Methods: Nationwide cohort of patients with newly diagnosed UC in the Veterans Affairs health care system was identified and divided into two categories: hypoalbuminemia (i.e., ≤ 3.5 gm/dL) or normal albumin levels (i.e., > 3.5 gm/dL) at the time of UC diagnosis. The exposure of interest was presence of hypoalbuminemia defined as albumin level ≤ 3.5 g/dL at the time of UC diagnosis. Patients were then followed over time to identify the use of ≥ 2 courses of corticosteroids (CS), thiopurines, anti-TNF medications and requirement of colectomy for UC management.

Results: The eligible study cohort included 802 patients, but 92 (11.4%) patients did not have their albumin levels checked at the time of UC diagnosis, and they were excluded. A total of 710 patients, who had albumin levels checked at time of UC diagnosis, were included in our study. Amongst them, 536 patients had a normal albumin level and 174 patients had hypoalbuminemia. Patients with hypoalbuminemia at diagnosis had a higher likelihood of ≥ 2 courses of CS use (adjusted HR = 1.7, 95%CI: 1.3-2.3), higher likelihood of thiopurine or anti- TNF use (adjusted HR = 1.72, 95%CI: 1.23-2.40) than patients with normal albumin level at diagnosis. There was a trend of higher likelihood of colectomy in hypoalbuminemic patients, but it was not statistically significant (Adjusted HR = 1.7, 95%CI: 0.90-3.25).

Conclusion: Hypoalbuminemia at disease diagnosis can serve as a prognostic marker to predict the clinical course of UC at the time of diagnosis.

Keywords: Albumin; Colectomy; Disease course; Prognostic marker; Ulcerative colitis.

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Conflict of interest statement

Conflict-of-interest statement: There were no conflicts of interest for this study.

Figures

Figure 1
Figure 1
Flow chart for assembly of the study cohort. CD: Crohn’s disease; UC: Ulcerative colitis.
Figure 2
Figure 2
Cumulative hazard functions for immunomodulator/anti-TNF (A), 2 or more courses of steroids (B), and ulcerative colitis-related colectomy (C).
See this image and copyright information in PMC

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