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. 2024 Jan 18;25(2):1177.
doi: 10.3390/ijms25021177.

Serum Amyloid A as a Potential Biomarker in Inflammatory Bowel Diseases, Especially in Patients with Low C-Reactive Protein

Marie Stute  1 , Martin Kreysing  1 , Markus Zorn  2 , Patrick Michl  1 , Annika Gauss  1
Affiliations

Serum Amyloid A as a Potential Biomarker in Inflammatory Bowel Diseases, Especially in Patients with Low C-Reactive Protein

Marie Stute et al. Int J Mol Sci. .

Abstract

The acute phase protein Serum Amyloid A (SAA) is synthesised by the liver in response to inflammatory stimuli. Previous studies have revealed that SAA may be a better biomarker of disease activity in inflammatory bowel disease (IBD) compared to C-reactive protein (CRP). This retrospective monocentric study evaluated whether SAA correlates with biomarkers like faecal calprotectin (FC), CRP, the Neutrophil to Lymphocyte ratio (NLR), the platelet count and clinical disease activity of IBD patients. Serum samples from the IBD outpatient clinic of the University Hospital Heidelberg were analysed for SAA concentrations if an FC concentration measurement was available from ±14 days to collection of the serum sample. Three hundred and six serum samples from 265 patients (166 with Crohn's disease, 91 with ulcerative colitis and 8 with IBD unclassified) met the inclusion criteria. There was a significant positive correlation between SAA and FC, CRP, NLR, platelet count and the Simple Clinical Colitis Activity Index (SCCAI). The cut-off for SAA serum concentration at 4.55 mg/L achieved a sensitivity of 57.5% and a specificity of 69.7% for the detection of active inflammation in IBD. SAA may be used as an additional biomarker in the disease monitoring strategy of IBD patients, especially in patients with low CRP concentrations.

Keywords: Crohn’s disease; SAA; Serum Amyloid A; biomarker; inflammatory bowel disease; ulcerative colitis.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Scatterplot for log(SAA) and log(FC), SAA Serum Amyloid A, FC faecal calprotectin.
Figure 2
Figure 2
Scatterplot for log(SAA) and log(CRP), SAA Serum Amyloid A, CRP C-reactive Protein.
Figure 3
Figure 3
Scatterplot for log(SAA) and log(NLR), SAA Serum Amyloid A, NLR Neutrophil-to-lymphocyte-ratio.
Figure 4
Figure 4
Scatterplot for log(SAA) and log(platelet count), SAA Serum Amyloid A.
Figure 5
Figure 5
Scatterplot for log(CRP) and log(FC), CRP C-reactive protein, FC faecal calprotectin.
Figure 6
Figure 6
ROC-analysis for SAA to detect active inflammation.
Figure 7
Figure 7
ROC-analysis for CRP to detect active inflammation.
Figure 8
Figure 8
Scatterplot for log(SAA) and log(FC) for the group CRP <5 mg/L, SAA Serum Amyloid A, FC faecal calprotectin.
See this image and copyright information in PMC

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