EVALUATING PREDICTIVE FACTORS FOR DISEASE ACTIVITY AMONG PATIENTS WITH INFLAMMATORY BOWEL DISEASE
Abstract
Aim: this study focused on evaluating several potential predictive factors for an increase in disease activity at 6 months for patients with inflammatory bowel disease (IBD). Material and methods: We performed a prospective cohort study, including patients who were evaluated at baseline and at 6 months. We assessed disease activity, clinical and biochemical parameters, anxiety and depression using Hospital Anxiety and Depression Scale (HADS) and sleep disorders using Pittsburgh Sleep Quality Index (PSQI) both at baseline and at 6 months. Results: Among the 59 patients who completed the follow-up, there was a statistically significant correlation between the presence of hyposideremia (p=0.023), hypercholesterolemia (p= 0.015) and altered psychological state (p=0.006) at baseline with an increase in disease activity at 6 months. Moreover, among the studied parameters, hypercholesterolemia (OR 5.18; 95% CI, 1.25-21.44), the neutrophil to lymphocyte ratio (OR 3.83; 95% CI, 1.87-7.83) and the depression score (OR 1.56; 95% CI, 1.22-2.01) were predictors for increase in disease activity at 6 months. Conclusions: Beyond usual inflammatory markers, neutrophil to lymphocyte ratio could have potential predictive value for systemic inflammation in IBD patients and could be easily assessed at routine evaluations. An integrative management, addressing several comorbidities, such as dyslipidemia and alteration of psychological distress could contribute to diminishing the risk for future disease flares in this patient category.
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