Joint Detection of Serum Vitamin D, Body Mass Index, and Tumor Necrosis Factor Alpha for the Diagnosis of Crohn's Disease.

OBJECTIVE: Vitamin D (VD) deficiency was reported to contribute to the progression of Crohn's disease (CD) and affect the prognosis of CD patients. This study investigated the role of serum VD, body mass index (BMI), and tumor necrosis factor alpha (TNF-α) in the diagnosis of Crohn's disease. METHODS: CD patients (n=76) and healthy subjects (n=76) were enrolled between May 2019 and December 2020. The serum 25-hydroxyvitamin D [25(OH)D] levels, BMI, and TNF-α levels, together with other biochemical parameters, were assessed before treatment. The diagnostic efficacy of the single and joint detection of serum 25(OH)D, BMI, and TNF-α was determined using receiver operating characteristic (ROC) curves. RESULTS: The levels of 25(OH) D, BMI, and nutritional indicators, including hemoglobin, total protein, albumin, and high-density lipoprotein cholesterol, were much lower, and the TNF-α levels were much higher in the CD patients than in the healthy subjects (P<0.05 for all). The areas under the ROC curve for the single detection of 25(OH)D, BMI, and TNF-α were 0.887, 0.896, and 0.838, respectively, with the optimal cutoff values being 20.64 ng/mL, 19.77 kg/m2, and 6.85 fmol/mL, respectively. The diagnostic efficacy of the joint detection of 25(OH)D, BMI, and TNF-α was the highest, with an area under the ROC curve of 0.988 (95%CI: 0.968-1.000). CONCLUSION: The joint detection of 25(OH)D, TNF-α, and BMI showed high sensitivity, specificity, and accuracy in CD diagnosis; thus, it would be effective for the diagnosis of CD in clinical practice.

[Diagnostic role of anti-saccharomyces cerevisiae and antineutrophil cytoplasmic autoantibodies in inflammatory bowel disease].

OBJECTIVE: To determine the accuracy of the assay using perinuclear antineutrophil cytoplasmic antibody (pANCA) and anti-saccharomyces cerevisiae antibodies (ASCA) in diagnosing ulcerative colitis (UC) and Crohn's disease (CD) and whether the presence of ASCA and pANCA antibodies could differentiate either CD from UC, or inflammatory bowel disease (IBD) from normal controls. METHODS: Serum samples were obtained from 34 patients with CD and 29 with UC, and from 25 normal volunteers. Diagnosis was established on clinical findings, X-ray or endoscopy and histology. Determination of ASCA and pANCA antibodies was performed using indirect immunofluorescence technique. RESULTS: 47.1% patients with CD against 69.0% patients with UC expressed pANCA (P < 0.05). Vice versa 58.6% patients with UC against 11.8% patients with CD expressed ASCA (P < 0.05). The sensibility, specificity and positive predictive value of combination of positive ASCA and negative pANCA to diagnosis CD was 0, 89.7% and 0 respectively, and those of combination of positive pANCA and negative ASCA to diagnosis of UC was 20.7%, 64.7% and 33.3% respectively. CONCLUSIONS: The positive of either ASCA or pANCA are not enough sensible to screen the IBD, but useful to diagnosis IBD. The combination pANCA and ASCA can not be as a serum differential diagnosis marker for IBD.