Abstract:

Objective　To analyze the relationship of the serum levels of milk fat globule epidermal growth factor 8 (MFG-E8), fucosylated haptoglobin (FUC-HPT), and visfatin with the disease activity index and prognosis in patients with ulcerative colitis (UC). Methods　A total of 170 patients with UC who were admitted to No. 215 Hospital of Shaanxi Nuclear Industry from June 2019 to June 2022 were selected as a disease group, while 170 healthy subjects who underwent physical examinations during the same period were selected as a healthy control group. There were 87 males and 83 females in the disease group; they were (44.03±8.44) years old; their body mass index (BMI) was (23.78±3.01) kg/m². There were 90 males and 80 females in the healthy control group; they were (45.17±7.59) years old; their BMI was (23.31±2.98) kg/m². The serum levels of MFG-E8, FUC-HPT, and visfatin were compared between the control group and the disease group. The disease group were further divided into mild, moderate, and severe activity groups based on their UC activity levels, and the serum levels of MFG-E8, FUC-HPT, and visfatin were compared between the 3 groups. The Pearson correlation analysis was used to examine the relationship of the serum levels of MFG-E8, FUC-HPT, and visfatin with the Mayo score. A two-year follow-up was conducted to record the patients' prognosis, and the disease group were categorized into poor and good prognosis groups based on their outcomes. The general data and serum levels of MFG-E8, FUC-HPT, and visfatin were compared between the poor and good prognosis groups. The multivariate logistic regression model was used to analyze the influencing factors of the patients' prognosis. The Pearson correlation analysis was again employed to investigate the correlation of the serum levels of MFG-E8, FUC-HPT, and visfatin with prognosis (with poor prognosis coded as 0 and good prognosis coded as 1). The independent sample t test, Mann-Whitney U test, analysis of variance, and LSD-t test were used for the statistical analysis. Results　Compared to the healthy control group, the disease group had a lower serum level of MFG-E8 (P<0.05) and higher levels of FUC-HPT and visfatin (both P<0.05). The serum levels of MFG-E8 in the moderate and severe activity groups were lower than that in the mild activity group, while the serum levels of FUC-HPT and visfatin were higher (all P<0.05). The serum level of MFG-E8 in the severe activity group was lower than that in the moderate activity group, while the levels of FUC-HPT and visfatin were higher (all P<0.05). The Pearson correlation analysis revealed that the serum MFG-E8 was negatively correlated with the Mayo score (r=-0.553; P<0.001), while the serum FUC-HPT and visfatin were positively correlated with the Mayo score (r=0.757 and 0.713; both P<0.001). The multivariate logistic regression analysis indicated that the score of Positive and Negative Affect Scale (PANAS), extraintestinal manifestations, increased basal plasmacytes, FUC-HPT, and visfatin were risk factors for poor prognosis in the patients (all P<0.05), whereas MFG-E8 was a protective factor (P<0.05). The Pearson correlation analysis showed that serum MFG-E8 was negatively correlated with poor prognosis (r=-0.345, P<0.001), and serum FUC-HPT and visfatin were positively correlated with poor prognosis (r=0.607 and 0.616; both P<0.001). Conclusion　The serum MFG-E8 level is abnormally reduced, and the serum FUC-HPT and visfatin levels are abnormally increased in patients with UC, which are correlated with the disease activity and are influencing factors for prognosis in patients with UC.

Key words: Ulcerative colitis,  , Milk fat globule-epidermal growth factor-8,  , Fucosylated haptoglobin,  , Visfatin,  , Disease activity index,  , Prognosis

摘要：

目的　分析血清乳脂肪球表皮生长因子-8（milk fat globule epidermal growth factor 8，MFG-E8）、岩藻糖基化触珠蛋白（fucosylated haptoglobin，FUC-HPT）、内脂素（Visfatin）水平与溃疡性结肠炎（ulcerative colitis，UC）患者疾病活动指数及预后的关系。方法　选取2019年6月至2022年6月陕西省核工业二一五医院收治的UC患者170例为疾病组，另选取同期于陕西省核工业二一五医院体检的健康受试者170例为健康对照组。疾病组男87例，女83例，年龄（44.03±8.44）岁，体重指数（body mass index，BMI）（23.78±3.01）kg/m2。健康对照组男90例，女80例，年龄（45.17±7.59）岁，BMI（23.31±2.98）kg/m2。比较健康对照组、疾病组血清MFG-E8、FUC-HPT、Visfatin水平。疾病组根据UC活动度分为轻、中、重度活动组，比较轻、中、重度活动组血清MFG-E8、FUC-HPT、Visfatin水平。采用Pearson相关性分析法分析血清MFG-E8、FUC-HPT、Visfatin水平与Mayo评分的相关性。随访2年，记录疾病组患者预后情况，根据预后情况分为不良组、良好组，比较不良组、良好组一般资料及血清MFG-E8、FUC-HPT、Visfatin水平。用多因素logistic回归模型分析UC患者预后的影响因素。采用Pearson相关性分析法分析血清MFG-E8、FUC-HPT、Visfatin水平与预后（预后不良赋值为0，预后良好赋值为1）的相关性。采用独立样本t检验、Mann-Whitney U检验、方差分析、LSD-t检验进行统计学分析。结果　疾病组血清MFG-E8水平低于健康对照组（P<0.05），血清FUC-HPT、Visfatin水平高于健康对照组（均P<0.05）。中、重度活动组血清MFG-E8水平低于轻度活动组（均P<0.05），血清FUC-HPT、Visfatin水平高于轻度活动组（均P<0.05）；重度活动组血清MFG-E8水平低于中度活动组（P<0.05），血清FUC-HPT、Visfatin水平高于中度活动组（均P<0.05）。Pearson相关性分析显示，血清MFG-E8与Mayo评分负相关（r=-0.553，P<0.001），血清FUC-HPT、Visfatin水平与Mayo评分正相关（r=0.757、0.713，均P<0.001）。多因素logistic回归模型分析显示，正性负性情绪量表（Positive and Negative Affect Scale，PANAS）评分、肠外表现、基底浆细胞增加、FUC-HPT、Visfatin是UC患者预后不良的危险因素（均P<0.05），MFG-E8是预后的保护性因素（P<0.05）。Pearson相关性分析显示，血清MFG-E8与UC患者预后不良负相关（r=-0.345，P<0.001），血清FUC-HPT、Visfatin与UC患者预后不良正相关（r=0.607、0.616，均P<0.001）。结论　UC患者血清MFG-E8水平异常降低，血清FUC-HPT、Visfatin水平异常升高，与疾病活动度具有相关性，是UC患者预后的影响因素。

关键词: 溃疡性结肠炎, 乳脂肪球表皮生长因子-8, 岩藻糖基化触珠蛋白, 内脂素, 疾病活动指数, 预后