Fu J, Zhang YY. Correlation between inflammatory markers and disease severity in ulcerative colitis. World J Gastrointest Surg 2025; 17(12): 108880 [DOI: 10.4240/wjgs.v17.i12.108880]
Corresponding Author of This Article
Jie Fu, MD, College of Traditional Chinese Medicine, Hubei University of Chinese Medicine, No. 188 Tanhualin, Wuhan 430065, Hubei Province, China. fujie266@126.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Dec 27, 2025 (publication date) through Dec 25, 2025
Times Cited of This Article
Times Cited (0)
Journal Information of This Article
Publication Name
World Journal of Gastrointestinal Surgery
ISSN
1948-9366
Publisher of This Article
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
Share the Article
Fu J, Zhang YY. Correlation between inflammatory markers and disease severity in ulcerative colitis. World J Gastrointest Surg 2025; 17(12): 108880 [DOI: 10.4240/wjgs.v17.i12.108880]
World J Gastrointest Surg. Dec 27, 2025; 17(12): 108880 Published online Dec 27, 2025. doi: 10.4240/wjgs.v17.i12.108880
Correlation between inflammatory markers and disease severity in ulcerative colitis
Jie Fu, Yue-Yu Zhang
Jie Fu, College of Traditional Chinese Medicine, Hubei University of Chinese Medicine, Wuhan 430065, Hubei Province, China
Yue-Yu Zhang, Department of Rehabilitation, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430014, Hubei Province, China
Yue-Yu Zhang, College of Acupuncture and Orthopedics, Hubei University of Chinese Medicine, Wuhan 430065, Hubei Province, China
Author contributions: Fu J was responsible for writing, data analysis, and visualization; Zhang YY took charge of conceptualization; and all authors thoroughly reviewed and endorsed the final manuscript.
Supported by the 2019 TCM Evidence-based Practice Capacity Building Project of the State Administration of Traditional Chinese Medicine, No. 2019XZZX-ZJ006; and the 2020 “Special Project on Traditional Chinese Medicine Ancient Books and Characteristic Technology Inheritance”, No. 295.
Institutional review board statement: This study was approved by the Medical Ethics Committee of the Central Hospital of Wuhan.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jie Fu, MD, College of Traditional Chinese Medicine, Hubei University of Chinese Medicine, No. 188 Tanhualin, Wuhan 430065, Hubei Province, China. fujie266@126.com
Received: July 11, 2025 Revised: August 18, 2025 Accepted: October 21, 2025 Published online: December 27, 2025 Processing time: 166 Days and 17.9 Hours
Abstract
BACKGROUND
Although histopathological examination via colonoscopy is the benchmark for ulcerative colitis (UC) diagnosis, its limitations underscore the urgency of identifying noninvasive diagnostic markers.
AIM
To investigate the clinical relevance of systemic inflammatory markers in assessing disease severity among patients with UC.
METHODS
In this study, 117 consecutive patients with UC hospitalized between January 2024 and January 2025 were analyzed and stratified by disease severity using the modified Mayo score: Mild (n = 37), moderate (n = 45), and severe (n = 35) groups. Demographic and clinical data were recorded, and serum concentrations of inflammatory markers-interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and C-reactive protein (CRP) - were measured and compared across the groups. Correlation analyses (Spearman’s rank) were conducted to evaluate the relationships between cytokine levels and disease severity. Disease severity-associated predictors were identified through regression (univariate and multivariate) analyses, supplemented by sensitivity testing to validate consistency. The diagnostic performance of inflammatory markers for disease progression was assessed using the receiver operating characteristic curve.
RESULTS
Serum IL-6, TNF-α, and CRP levels exhibited a significant stepwise increase with worsening UC severity. Each inflammatory marker demonstrated a strong positive correlation with disease severity. Multivariate analysis identified smoking history, alcohol abuse, IL-6, TNF-α, and CRP as independent predictors of disease progression. In the sensitivity testing, directional effects of these variables were aligned (all odds ratios > 1), indicating robust results. Receiver operating characteristic analysis indicated that the combined cytokine panel demonstrated superior diagnostic accuracy (area under the curve 0.917, 88.6% sensitivity, 80.5% specificity) when compared with individual markers (area under the curves, 0.763-0.820).
CONCLUSION
IL-6, TNF-α, and CRP levels strongly correlate with the progression of UC and may serve as reliable biomarkers for disease activity. The combined measurement of these markers could facilitate the early identification of high-risk patients, enabling prompt delivery of clinical intervention and personalized management.
Core Tip: The study evaluated whether interleukin-6, tumor necrosis factor-α, and C-reactive protein levels correlate with the severity of ulcerative colitis (UC). Analyses confirm strong positive relationships, supporting their utility as noninvasive biomarkers for UC progression. Of note, the interleukin-6 + tumor necrosis factor-α + C-reactive protein combination outperformed single-marker testing in identifying severe UC cases.
