Researchers Identify Key Blood Biomarkers for Monitoring Ulcerative Colitis
China: A new study published in the International Journal of General Medicine highlights the growing importance of blood-based inflammatory markers in evaluating ulcerative colitis (UC).
Conducted by Zhang Chenfei and colleagues from the Xinjiang Uygur Autonomous Region People’s Hospital, Urumqi, the research explores how the systemic immune-inflammatory index (SII) and several related indices reflect disease activity in UC patients.
The investigators analyzed data from 616 individuals with UC and 211 healthy controls to better understand how simple, routinely available blood tests can support clinical assessment. Disease activity was determined using the modified Mayo score, allowing patients to be grouped into remission or active disease categories. The active group was further divided into mild, moderate, and severe subgroups, providing a detailed look at how inflammatory markers vary with symptom burden.
The study revealed the following findings:
- Most inflammatory indices—including SII, NLR, PLR, and NPAR—were significantly higher in UC patients compared to healthy controls.
- LMR and LHR were lower in UC patients, indicating immune dysregulation.
- Inflammatory markers were notably higher in patients with active UC compared to those in remission.
- Levels of SII, NLR, NPAR, NHR, and MHR increased progressively with disease severity, from mild to severe UC.
- These findings suggest a strong correlation between blood-based inflammatory markers and UC activity and severity.
Correlation analysis supported these findings, revealing positive and statistically significant associations between elevated inflammatory markers and both disease activity and severity. To further assess their clinical utility, the authors evaluated the predictive performance of these indices using ROC curve analysis. Most markers demonstrated meaningful diagnostic ability, with area-under-the-curve (AUC) values exceeding 0.60. Among them, NPAR emerged as the most powerful predictor, achieving an AUC of 0.854 for identifying active and severe UC.
The study emphasizes that these blood-based indices are non-invasive, accessible, and cost-effective, making them valuable tools in day-to-day clinical decision-making. Their ability to reflect not only the presence of inflammation but also its intensity may help clinicians optimize monitoring strategies, adjust therapy proactively, and identify high-risk patients earlier.
However, the authors acknowledge important limitations. The study’s single-center, retrospective design may limit generalizability, and unmeasured confounding factors cannot be entirely ruled out. Although the sample size was substantial, certain subgroup comparisons may still lack statistical power. The researchers note that their findings should be interpreted cautiously and validated through larger, multicenter prospective studies.
The study reinforces the diagnostic potential of SII, NLR, PLR, NPAR, and related inflammatory indices in ulcerative colitis, with NPAR demonstrating the strongest predictive value. The authors suggest that future research should explore combining these indices with genomic or microbiome-based tools to build more comprehensive, personalized approaches to UC assessment.
Reference:
Chenfei, Z., Ainiwaer, Z., & Xiaoling, H. (2025). A Study of the Correlation Between the Inflammatory Index and Disease Activity in Ulcerative Colitis. International Journal of General Medicine, 18, 7143–7152. https://doi.org/10.2147/IJGM.S552515
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