JGH Open · Published 2026-05-01 · DOI 10.1002/jgh3.70405
ABSTRACT Aim Fecal occult blood concentration, fecal calprotectin (FC) level, serum C‐reactive protein (CRP) level, and erythrocyte sedimentation rate (ESR) are valuable biomarkers for ulcerative colitis (UC). However, their clinical utility for longitudinal disease assessment remains unclear. This retrospective, observational study assessed correlations between biomarker changes and endoscopic activity scores in UC. Methods Spearman's rank correlation coefficient analysis was applied to examine the relationship between longitudinal variations in endoscopic activity scores, including the Mayo endoscopic subscore (MES), ulcerative colitis endoscopic index of severity (UCEIS), and sum of Mayo endoscopic subscores (S‐MES), and corresponding biomarker changes in patients with UC. Results The study included 97 patients, contributing to 145 observation intervals (48 contributed two intervals each and 49 contributed one each). All endoscopic scores and biomarkers were significantly correlated with disease activity, with corresponding increases or decreases (p < 0.05). Changes in MES and S‐MES correlated most strongly with FC level changes (r = 0.62 and 0.66, respectively). Changes in the UCEIS exhibited the strongest correlation with fecal occult blood concentration changes (r = 0.67). Changes in fecal occult blood and FC (r = 0.55) and in serum CRP and ESR (r = 0.58) were strongly correlated. Conclusions All four biomarkers reflected endoscopic activity in UC. Changes in fecal occult blood concentration and FC level had stronger correlations with endoscopic score changes than blood biomarker concentration changes. FC assessment is valuable for monitoring inflammatory activity during remission maintenance, whereas fecal occult blood concentration reflects mucosal bleeding. Serum CRP level and ESR are useful adjunctive biomarkers, particularly in cases of increased disease activity.
Abstract from DOAJ. Public domain (CC0 1.0).
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