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. 2022 Sep 16:2022:9171436.
doi: 10.1155/2022/9171436. eCollection 2022.

The Correlation between Endotoxin, D-Lactate, and Diamine Oxidase with Endoscopic Activity in Inflammatory Bowel Disease

Qi Zhang  1 , Xin Gao  2 , Jixiong Wu  3 , Min Chen  4
Affiliations

The Correlation between Endotoxin, D-Lactate, and Diamine Oxidase with Endoscopic Activity in Inflammatory Bowel Disease

Qi Zhang et al. Dis Markers. .

Abstract

Methods: A total of 149 eligible IBD patients including 82 Crohn disease (CD) and 67 Ulcerative colitis (UC) who had received both endoscopic examination and intestinal barrier function detection in our hospital were enrolled in this study. Endoscopic activity was estimated by the Simple Endoscopic Score (SES-CD) for Crohn's Disease and the ulcerative colitis endoscopic index of severity (UCEIS) for ulcerative colitis. The predictive value and optimal predictive thresholds for those biomarkers were determined by receiver operating characteristic analysis.

Results: For UC patients, DAO, D-lactate, and ETX showed better correlation with UCEIS than erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) and exhibited satisfactory predictive value in predicting remission. Among patients with CD, DAO and ETX not only showed a better correlation than WBC, ESR, and CRP with SES-CD but also capable to identify more severe patients.

Conclusion: DAO and ETX could be used to distinguish different endoscopic activity of CD. DAO, D-lactate, and ETX could predict UC endoscopic remission.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
In active CD patients (SES − CD > 2), the DAO levels of severe groups were higher than moderate groups (P < 0.05, (a)), moderate groups were higher than mild groups (P < 0.001, (a)), and severe groups were significantly higher than mild groups (P < 0.001, (a)).The ETX levels of severe groups were higher than moderate groups (P < 0.05, (b)), moderate groups were higher than mild group (P < 0.01, (b)), and severe groups were significantly higher than mild groups (P < 0.01, (b)). There was no difference in D-lactate level between each group in active CD patients (P > 0.05 for all, (c)).
Figure 2
Figure 2
Receiver operator curves (ROCs) of DAO, D-lactate, ETX, and inflammatory markers in detecting IBD severity corresponding to different endoscopic scoring thresholds. The results showed that DAO and ETX are valuable in differentiating CD patients with different endoscopic activity levels. The ROC curve at SES − CD ≤ 6 is shown in (a), and the diagnostic value of DAO is better than ETX. As well as the ROC curve at SES − CD < 16 is shown in (b), and the diagnostic value of DAO is better than ETX. D-lactate, WBC, ESR, and CRP failed to predict CD endoscopy severity.
Figure 3
Figure 3
ROC curve of DAO, D-lactate, ETX, and inflammatory markers in predicting CD endoscopic remission. (a) ROC curve at SES − CD ≤ 2. Studies showed that DAO, D-lactate, and ETX values at SES − CD ≤ 2 could not predict the endoscopic remission of CD (P > 0.05), nor could WBC, ESR, or CRP. (b) ROC curve at SES − CD ≤ 3. DAO and ETX could predict endoscopic remission of CD with AUC of 0.72 (P = 0.008) and 0.67 (P = 0.04), respectively, while D-lactate failed to predict remission (P > 0.05).
Figure 4
Figure 4
In active UC patients, there was no significant difference in DAO and D-lactate between mild-moderate and severe patients (P > 0.05 for both), while ETX levels of severe group were higher than mild-moderate group (P < 0.05).
Figure 5
Figure 5
The ROC curves of DAO, D-lactate, ETX, and inflammatory markers for detecting the severity of UC endoscopy showed that the above indicators failed to distinguish the endoscopic severity of UC.
Figure 6
Figure 6
ROC curve of DAO, D-lactate, ETX, and inflammatory markers for UC endoscopic remission (UCEIS ≤ 1). The results showed that DAO, D-lactate, and ETX had diagnostic value in differentiating remission (UCEIS ≤ 1) from activity (UCEIS > 1) of UC patients.
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