Abstract
Background
The relationship between nutritional indices and treatment response in ulcerative colitis (UC) remains poorly characterized.
Objectives
To assess the discriminatory ability of Geriatric Nutritional Risk Index (GNRI), Malnutrition Universal Screening Tool (MUST), and Prognostic Nutritional Index (PNI) in evaluating the clinical efficacy of vedolizumab (VDZ) in patients with moderate-to-severe UC.
Design
A retrospective multicenter study.
Methods
This study enrolled moderate-to-severe UC patients receiving VDZ at three centers in northern China from 2021 to 2025. The relationship between baseline nutritional indices and clinical remission, alongside conventional biomarkers, was analyzed. Discriminatory performance was evaluated using receiver operating characteristic curves and area under the curve (AUC) analysis.
Results
A total of 184 patients were included. At week 14, multivariable logistic regression identified GNRI, PNI and MUST as factors significantly associated with clinical remission. GNRI showed the strongest correlation with clinical remission (r=0.340,
p
0.001), followed by HGB (r=0.316,
p
0.001), PNI (r=0.308,
p
0.001), PLR (r=-0.271,
p
0.001), MUST (r=-0.216,
p=
0.003), and NLR (r=-0.163,
p=
0.027). GNRI had the highest AUC (0.697), followed by HGB (0.683), PNI (0.678), Alb (0.660), PLR (0.657) and MUST (0.614). GNRI exhibited significantly greater discriminatory ability for 14-week clinical remission than Alb (
p
=0.018) and MUST (
p=
0.041). No significant differences in diagnostic accuracy were found between GNRI, HGB, PNI, PLR, and NLR (
p>
0.05). At week 30 and 54, multivariate analysis showed that only baseline HGB remained independently associated with remission.
Conclusions
Patients with lower nutritional risk—as reflected by higher GNRI and PNI scores, alongside lower MUST scores-were significantly more likely to achieve clinical remission at week 14.