Association between serum bilirubin and mucosal healing among Japanese patients with ulcerative colitis: a cross-section
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ORIGINAL ARTICLE
Association between serum bilirubin and mucosal healing among Japanese patients with ulcerative colitis: a cross-sectional study Kana Shiraishi 1 & Shinya Furukawa 2 & Sen Yagi 3 & Masakazu Hanayama 1 & Kenichirou Mori 4 & Tomoyuki Ninomiya 4 & Seiyuu Suzuki 5 & Katsuhisa Ohashi 6 & Hidehiro Murakami 3 & Eiji Takeshita 7 Yoshio Ikeda 8 & Yoichi Hiasa 1
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Accepted: 8 October 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose Bilirubin is known to have antioxidant effects. Several pieces of evidence regarding association between serum bilirubin and UC exist. Three studies found that serum bilirubin was inversely associated with severity of ulcerative colitis (UC), but no evidence regarding an association between serum bilirubin and mucosal healing (MH) has yet been shown. Thus, we evaluated this issue among Japanese patients with UC. Methods The study subjects consisted of 304 Japanese patients with UC. Serum total bilirubin and indirect bilirubin were divided into quartiles on the basis of the distribution of all study subjects (low, moderate, high, and very high). Several endoscope specialists were responsible for evaluating MH, which was defined as a Mayo endoscopic subscore of 0. The information on clinical remission was collected using medical records. Results The mean age was 49.9 years, the percentage of male patients was 59.2%, and the percentage of MH was 29.3%. High serum total bilirubin was independently positively associated with MH (OR 2.26 [95%CI 1.13–4.61]. However, after adjustment for confounding factors, the association between total bilirubin and MH disappeared. Very high serum indirect bilirubin was independently positively associated with MH (OR 2.31 [95%CI 1.10–5.00], p for trend = 0.026). No association between bilirubin and clinical remission was found. Conclusions Among Japanese patients with UC, serum indirect bilirubin, but not total bilirubin, was significantly positively associated with MH but not clinical remission. Keywords Bilirubin . Mucosal healing . Ulcerative colitis
Introduction Ulcerative colitis (UC) is a chronic inflammatory bowel disease (IBD) characterized by a disease course involving * Shinya Furukawa [email protected] 1
Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295, Japan
2
Health Services Center, Ehime University, Bunkyo, Matsuyama, Ehime 790-8577, Japan
3
Department of Internal Medicine, Saiseikai Matsuyama Hospital, Yamanishi, Matsuyama, Ehime 791-8026, Japan
relapses and remissions [1]. The prevalence of UC is on the rise, and it is widespread in different regions around the world [2]. The increase in the incidence of UC has been especially pronounced in newly industrialized countries including China. 4
Department of Gastroenterology, Ehime Prefectural Central Hospital, Kasuga, Matsuyama, Ehime 790-0024, Japan
5
Department of Gastroenterology, Sumitomo Besshi Hospital, Oji, Niihama, Ehime 792-8543, Japan
6
Ohashi Clini
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