P282 Fecal calprotectin is correlated to Seo index in prediction of relapse in Iranian patients with Ulcerative Colitis
S.V. Hosseini1, P. Jafari2, S.A. Taghavi3, A. Rezaianzadeh4, M. Moini3, M. Mehrabi3, A.R. Safarpour*3
1Shiraz University of Medical Sciences, Colorectal Research Center, Shiraz, Iran, Islamic Republic of, 2Shiraz University of Medical Sciences, Biostatistics ward, Shiraz, Iran, Islamic Republic of, 3Shiraz University of Medical Sciences, Gastroenterohepatology Research Center, Shiraz, Iran, Islamic Republic of, 4Shiraz University of Medical Sciences, Nutrition and Health School, Shiraz, Iran, Islamic Republic of
The natural clinical course of Ulcerative Colitis (UC) is characterized by episodes of relapse and remission. Fecal Calprotectin (FC) is a relatively new marker of intestinal inflammation and is an available, non expensive tool for predicting relapse of quiescent UC. Seo colitis activity index also is a clinical index for assessment of the severity of UC. The present study aimed to evaluate of the accuracy of FC and Seo colitis activity index as well as their correlation in prediction of UC exacerbation.
In this study, 157 patients with clinical and endoscopic diagnosis of UC who were selected randomly from 1273 registered patients in Fars province's IBD registry center were followed, since October 2012 to October 2013, for 12 months, or shorter, if they had a relapse. Two patients left the study before completion and one patient had relapse because of discontinuation of drugs. The participants' clinical and serum factors were evaluated every three months. Also Stool samples were collected at the beginning of the study and every three months and FC concentration (commercially available enzyme linked immunoassay) and Seo Index were assessed. Univariate analysis, multiple variable logistic regression, Receiver Operating Characteristics (ROC) curve analysis, and Pearson's correlation test (r), were used for statistical analysis of the data.
According to the Results, 74 patients (48.1%) relapsed during the follow up (33 men and 41 women). Mean ± SD of FC was 862.82 ± 655.97micro. g/g and 163.19 ± 215.85micro.g/g in relapsing and non-relapsing patients, respectively (P<0.001). Multiple logistic regression analysis revealed that age, number of previous relapses, FC and Seo index were significant predictors of relapse. ROC curve analysis of FC level and Seo activity index for prediction of relapse demonstrated area under the curve of 0.882 (P<0.001) and 0.921(P<0.001) respectively. Besides FC level of 341 micro.g/g was identified as the cut-off point with 11.2% and 79.7% relapse rate below and above this point, respectively. Additionally Pearson correlation coefficient (r) between FC and Seo index was significant in prediction of relapse (r=0.63, P<0.001).
As a simple and noninvasive marker, FC is highly accurate and is significantly correlated to Seo activity index in prediction of relapse in the course of quiescent UC in Iranian patients.