Leucine-rich alpha-2 glycoprotein reflects transmural inflammation assessed by through-the-scope endoscopic ultrasonography: A prospective study in small-bowel Crohn’s disease

Table 1 Baseline characteristics of the cohort, n (%)/median interquartile range

Characteristics	n = 132
Male	98 (74.2)
Median age, year	32 (22-40)
Median disease duration, months	36 (12-60)
Location
L1 (ileal)	132 (100)
L2 (colonic)	0 (0)
L3 (ileocolonic)	0 (0)
L4 (upper gastrointestinal)	3 (2.3)
Behavior
B1 (nonstricturing, nonpenetrating)	79 (59.8)
B2 (stricturing)	51 (38.6)
B3 (penetrating)	2 (1.5)
Concomitant treatment
No therapy	7 (5.3)
Corticosteroid	12 (9.1)
Azathioprine	20 (15.2)
Biologic agents	105 (79.5)
Previous intestinal resection	6 (4.5)
Median CDAI score	129 (89-198)
Clinical remission (CDAI ≤ 150)	78 (59.1)
Median SES-CD score	5 (0-10)
Median CRP (mg/L), n = 129	1.58 (0.60-6.92)
Median LRG (μg/mL)	14.64 (10.58-19.09)
Median FC (μg/g), n = 121	172.97 (44.75-602.55)
Transmural activity by DBE-EUS
TWT, mm	2.90 (2.32-3.70)
MT, mm	0.80 (0.60-0.90)
SMT, mm	0.90 (0.72-1.20)
MPT, mm	0.70 (0.60-0.80)
TWT ≥ 2.65 mm	81 (61.3)
SMT ≥ 0.95 mm	64 (48.4)
Bowel-wall stratification (clear)	92 (69.6)
Serosal integrity (smooth)	126 (95.4)

Unless otherwise indicated, percentages were calculated using the overall cohort (n = 132) as the denominator. Variables with missing data were presented using variable-specific denominators. CDAI: Crohn’s disease activity index; SES-CD: Simple endoscopic score for Crohn’s disease; CRP: C-reactive protein; LRG: Leucine-rich alpha-2 glycoprotein; FC: Fecal calprotectin; DBE-EUS: Endoscopic ultrasonography during double-balloon enteroscopy; TWT: Total wall thickness; SMT: Submucosal thickness; MT: Mucosal thickness; MPT: Muscularis propria thickness.

Table 2 Area under the curve, cutoff values, sensitivity, specificity in the overall cohort, n (%)

Outcome	n	Variable	AUC	95%CI	P value	Cutoff	Sn	Sp
TWT ≥ 2.65 mm	81 (61.3)	LRG	0.875	0.816-0.935	< 0.0001	14.68 μg/mL	0.753	0.922
		CRP	0.732	0.641-0.822	< 0.0001	1.12 mg/L	0.753	0.686
		FC	0.847	0.780-0.913	< 0.0001	124.89 μg/g	0.778	0.824
		SES-CD	0.870	0.808-0.933	< 0.0001	2	0.914	0.784
		CDAI	0.769	0.687-0.851	< 0.0001	133.5	0.642	0.784
SMT ≥ 0.95 mm	64 (48.4)	LRG	0.833	0.764-0.902	< 0.0001	15.80 μg/mL	0.750	0.838
		CRP	0.720	0.631-0.810	< 0.0001	1.17 mg/L	0.781	0.647
		FC	0.837	0.766-0.908	< 0.0001	224.54 μg/g	0.766	0.853
		SES-CD	0.847	0.780-0.913	< 0.0001	4.5	0.813	0.779
		CDAI	0.756	0.675-0.837	< 0.0001	136.5	0.688	0.735

Missing C-reactive protein and fecal calprotectin values were imputed using predictive mean matching before receiver operating characteristic analysis. AUC: Area under the curve; CI: Confidence interval; Sn: Sensitivity; Sp: Specificity; TWT: Total wall thickness; SMT: Submucosal thickness; CRP: C-reactive protein; LRG: Leucine-rich alpha-2 glycoprotein; FC: Fecal calprotectin; CDAI: Crohn’s disease activity index; SES-CD: Simple endoscopic score for Crohn’s disease.

Table 3 Area under the curve, cutoff values, sensitivity, specificity among patients in clinical remission, n (%)

Outcome	n	Variable	AUC	95%CI	P value	Cutoff	Sn	Sp
TWT ≥ 2.65 mm	37 (47.4)	LRG	0.871	0.794-0.948	< 0.0001	13.99 μg/mL	0.703	0.951
		CRP	0.732	0.614-0.849	< 0.0001	1.02 mg/L	0.784	0.659
		FC	0.827	0.732-0.922	< 0.0001	118.24 μg/g	0.703	0.854
SMT ≥ 0.95 mm	26 (33.3)	LRG	0.875	0.790-0.960	< 0.0001	15.72 μg/mL	0.692	0.942
		CRP	0.699	0.576-0.822	0.001	1.04 mg/L	0.808	0.596
		FC	0.837	0.733-0.940	< 0.0001	162.39 μg/g	0.769	0.846

Missing C-reactive protein and fecal calprotectin values were imputed using predictive mean matching before receiver operating characteristic analysis. AUC: Area under the curve; CI: Confidence interval; Sn: Sensitivity; Sp: Specificity; TWT: Total wall thickness; SMT: Submucosal thickness; CRP: C-reactive protein; LRG: Leucine-rich alpha-2 glycoprotein; FC: Fecal calprotectin.