From blood to bowel: correlating serological markers with mucosal healing and inflammation in patients with inflammatory bowel disease

Background Inflammatory bowel disease (IBD) is a systemic disease characterized by chronic inflammation of the gastrointestinal tract. Serological testing has the advantages of wide sources and easy detection. Objective To explore the correlation between the serological markers and endoscopic mucosal healing and histological healing. We also explored the predictive value of individual and combined detection on the disease activity of ulcerative colitis (UC) and Crohn’s disease (CD) and provide reference for clinical non-invasive evaluation. Methods We retrospectively analyzed 267 IBD patients treated at our hospital from May 2020 to June 2024. Patients were classified based on endoscopic, pathological, or imaging results into UC (141 patients) and CD (126 patients). UC patients were further divided into mucosal healing (32 cases, IMES ≤ 1), mild (41 cases, 3 ≤ IMES ≤ 5), moderate (49 cases, 6 ≤ IMES ≤ 10), and severe (19 cases, 11 ≤ IMES ≤ 12) phases by the Improved Mayo Endoscopic Score (IMES). CD patients were categorized by the Crohn’s Disease Activity Index (CDAI). According to the Geboes score, patients were divided into a histological healing group (n=63) and a histological activity group (n=204). Pearson analysis examined correlations and ROC analysis assessed their predictive value. Results In severe cases, ALB and PA were lower, and CRP, ESR, NLR, and PLR were higher than in moderate cases (P Conclusion Differences in serum ALB, PA, CRP, ESR, NLR, PLR were correlated with mucosal healing and inflammation in IBD patients. Combined detection offers clinical value in predicting disease activity.