Albuminasaprognosticmarkerforulcerativecolitis

摘要： AIMToevaluatetheroleofalbuminatthetimeofulcerativecolitis(UC)diagnosisinpredictingtheclinicalcourseofdisease.METHODSNationwidecohortofpatientswithnewlydiagnosedUCintheVeteransAffairshealthcaresystemwasidentifiedanddividedintotwocategories:hypoalbuminemia(i.e.,≤3.5gm/dl)ornormalalbuminlevels(i.e.,>3.5gm/dl)atthetimeofUCdiagnosis.Theexposureofinterestwaspresenceofhypoalbuminemiadefinedasalbuminlevel≤3.5g/dlatthetimeofUCdiagnosis.Patientswerethenfollowedovertimetoidentifytheuseof≥2coursesofcorticosteroids(CS),thiopurines,anti-TNFmedicationsandrequirementofcolectomyforUCmanagement.RESULTSTheeligiblestudycohortincluded802patients,but92(11.4%)patientsdidnothavetheiralbuminlevelscheckedatthetimeofUCdiagnosis,andtheywereexcluded.Atotalof710patients,whohadalbuminlevelscheckedattimeofUCdiagnosis,wereincludedinourstudy.Amongstthem,536patientshadanormalalbuminleveland174patientshadhypoalbuminemia.Patientswithhypoalbuminemiaatdiagnosishadahigherlikelihoodof≥2coursesofCSuse(adjustedHR=1.7,95%CI:1.3-2.3),higherlikelihoodofthiopurineoranti-TNFuse(adjustedHR=1.72,95%CI:1.23-2.40)thanpatientswithnormalalbuminlevelatdiagnosis.Therewasatrendofhigherlikelihoodofcolectomyinhypoalbuminemicpatients,butitwasnotstatisticallysignificant(AdjustedHR=1.7,95%CI:0.90-3.25).CONCLUSIONHypoalbuminemiaatdiseasediagnosiscanserveasaprognosticmarkertopredicttheclinicalcourseofUCatthetimeofdiagnosis. ... （共9页）