Leucine-rich alpha-2 glycoprotein as a superior biomarker to C-reactive protein for detecting small bowel lesions in Crohn’s disease

Table 1 Overall characteristics of the study participants, n (%)

Variables	n = 133
Sex, male	103 (77.4)
Age, median years (IQR)	38 (28-48.5)
BMI, median years (IQR)	20.9 (19.25-24.25)
Period between endoscopy and LRG measurement, median days (IQR)	18 (3-40)
Location
L1: Ileal	43 (32.3)
L2: Colonic	10 (7.5)
L3: Ileocolonic	80 (60.2)
Behavior
B1: Inflammatory	51 (38.3)
B2: Stricturing	54 (40.6)
B3: Penetrating	28 (21.0)
Previous intestinal resection	42 (31.6)
Concomitant treatment
5-Aminosalicylic acid	70 (52.6)
Steroids	1 (0.8)
Immunomodulator	34 (25.5)
Biologics	96 (72.2)
Anti-TNF alpha	44 (33.1)
Anti-integrin	4 (3.0)
Anti-interleukin 12/23 p40	40 (30.1)
Anti-interleukin 23 p19	6 (4.5)
JAK inhibitor	1 (0.8)
LRG, median μg/mL (IQR)	12.5 (9.4-18.0)
CRP, median mg/dL (IQR)	0.1 (0.03-0.26)
Albumin, g/dL (IQR)	4.2 (3.9-4.5)
HBI (IQR)	0 (0-2)
mSES-CD in the ileum (IQR)	3 (0-4)
mSES-CD in the colon (IQR)	0 (0-3)

IQR: Interquartile range; BMI: Body mass index; TNF: Tumor necrosis factor; JAK: Janus kinase; LRG: Leucine-rich alpha-2 glycoprotein; CRP: C-reactive protein; HBI: Harvey-Bradshaw index; mSES-CD: Modified simple endoscopic score for Crohn’s disease.

Table 2 Characteristics of the patients in each group, n (%)

Variables	EH group (n = 61)	Ileal group (n = 43)	Colonic group (n = 16)	Ileocolonic group (n = 13)	P value
Sex, male	46 (75.4)	34 (79.1)	12 (75.0)	11 (84.6)	0.886
Age, median years (IQR)	35 (25.5-47)	38 (29-50.5)	42.5 (25.5-48.3)	36 (21.5-51)	0.870
BMI, median years (IQR)	20.9 (19.4-24.4)	21.2 (19.3-24.6)	20.8 (18.8-23.8)	20.2 (18.3-23.1)	0.760
Location					N/A
L1: Ileal	20 (35.0)	23 (56.1)	0 (0)	0	-
L2: Colonic	6 (9.8)	0 (0)	4 (25.0)	0	-
L3: Ileocolonic	35 (57.4)	20 (32.8)	12 (75.0)	13 (100)	-
Behavior					0.0002
B1: Inflammatory	35 (57.4)	4 (6.6)	7 (43.8)	5 (38.5)	-
B2: Stricturing	15 (24.6)	28 (45.9)	6 (37.5)	5 (38.5)	-
B3: Penetrating	11 (18.0)	11 (18.0)	3 (18.8)	3 (23.1)	-
Previous intestinal resection	9 (14.8)	20 (32.8)	7 (43.8)	6 (46.2)	0.002
Concomitant treatment
5-Aminosalicylic acid	35 (57.4)	24 (39.3)	6 (37.5)	5 (38.5)	0.356
Steroids	0 (0)	1 (16.4)	0 (0)	0 (0)	0.541
Immunomodulator	17 (27.9)	13 (21.3)	3 (18.8)	1 (7.7)	0.357
Biologics	51 (83.6)	26 (42.6)	11 (68.8)	6 (46.2)	0.012
Anti-TNF alpha	29 (47.5)	6 (9.8)	5 (31.3)	4 (30.8)	0.005
Anti-integrin	1 (16.4)	2 (3.3)	1 (6.3)	0 (0)	0.622
Anti-interleukin; 12/23 p40	18 (29.5)	16 (26.2)	5 (31.3)	1 (7.7))	0.245
Anti-interleukin; 23 p19	3 (4.9)	2 (3.3)	0 (0)	1 (7.7)	0.780
JAK inhibitor	0 (0)	1 (1.6)	0 (0)	0 (0)	0.655

IQR: Interquartile range; BMI: Body mass index; TNF: Tumor necrosis factor; JAK: Janus kinase; N/A: Not applicable.

Table 3 Area under curves, cut-off value, sensitivity, specificity, and accuracy of leucine-rich alpha-2 glycoprotein and C-reactive protein in predicting endoscopic healing in the ileum and colon

Ileum/colon	Variables	AUC (95%CI)	Cutoff value	Sensitivity (95%CI)	Specificity (95%CI)	Accuracy	P value (95%CI)
Ileum	LRG	0.809 (0.724-0.894)	12.4 μg/mL	0.767 (0.623-0.869)	0.787 (0.669-0.871)	0.779	0.024 (0.017-0.194)
	CRP	0.705 (0.602-0.808)	0.20 mg/dL	0.465 (0.325-0.611)	0.869 (0.762-0.932)	0.702
Colon	LRG	0.863 (0.747-0.978)	12.4 μg/mL	0.875 (0.640-0.978)	0.787 (0.669-0.871)	0.805	0.295 (-0.050 to 0.166)
	CRP	0.805 (0.689-0.921)	0.13 mg/dL	0.750 (0.505-0.898)	0.738 (0.616-0.832)	0.740

AUC: Area under the curve; CI: Confidence interval; LRG: Leucine-rich alpha-2 glycoprotein; CRP: C-reactive protein; EH: Endoscopic healing.

Table 4 Area under curves, cut-off value, sensitivity, and specificity of leucine-rich alpha-2 glycoprotein in predicting endoscopic healing in the small intestine determined using balloon-assisted enteroscopy according to the previous and present studies

Ref.	Number of patients	AUC (95%CI)	Cut-off value	Sensitivity	Specificity
Kawamoto et al[25]	108	0.850 (0.766-0.933)	13.4 μg/mL	0.79	0.82
Kawamoto et al[26]	75	0.805 (0.703-0.907)	13 μg/mL	0.71	0.80
Kawamura et al[27]	36	0.885 (0.744-1.000)	8.9 μg/mL	0.926	0.778
Present study	104	0.809 (0.724-0.894)	12.4 μg/mL	0.767	0.787

AUC: Area under the curve; CI: Confidence interval.