Endoscopy 2025; 57(S 02): S435
DOI: 10.1055/s-0045-1806114
Abstracts | ESGE Days 2025
ePosters

Serum Albumin: A Marker of Inflammation or Malnutrition in IBD ?

M Oussama
1   Sahloul Hospital, Sousse, Tunisia
,
D Wafa
1   Sahloul Hospital, Sousse, Tunisia
,
N Elleuch
1   Sahloul Hospital, Sousse, Tunisia
,
H Aya
1   Sahloul Hospital, Sousse, Tunisia
,
H Jaziri
1   Sahloul Hospital, Sousse, Tunisia
,
A Ben Slama
1   Sahloul Hospital, Sousse, Tunisia
,
A Braham
1   Sahloul Hospital, Sousse, Tunisia
,
M Ksiaa
1   Sahloul Hospital, Sousse, Tunisia
› Author Affiliations
 

Aims To date, it remains unclear whether serum albumin is more closely associated with nutritional status or disease activity in patients with Inflammatory Bowel Disease (IBD). The main objectives of this study were to examine the association between albumin, inflammation, and malnutrition in patients with IBD and to determine whether serum albumin is an appropriate indicator for either or both of these processes in patients with IBD.

Methods We conducted a single-center retrospective study in the gastroenterology department at Sahloul Hospital – Sousse. A total of 224 patients followed for IBD were included. Nutritional status was assessed according to the criteria of the European Society for Clinical Nutrition and Metabolism (ESPEN). Serum albumin was compared with nutritional status, the Harvey Bradshaw Index for Crohn’s disease, the Mayo Score for ulcerative colitis, and C-reactive protein (CRP) as a marker of inflammation.

Results In patients with active disease, the mean CRP was 27 mg/dL (± 45.8) compared to 3.5 mg/dL (± 3.9) in patients in remission. The mean albumin level was 36.7 g/L (± 4.1) versus 39.9 g/L (± 3.4) in patients in clinical remission. These differences were statistically significant, with p<0.001. Additionally, we found a strong negative correlation between albumin levels and the Mayo Clinic score for ulcerative colitis (r=-0.697; p<0.001), as well as the Harvey Bradshaw Index for Crohn’s disease (r=-0.349; p<0.001). Bivariate analysis showed a moderate to strong bilateral negative correlation between albumin and CRP (r=-0.537; p<0.001). Furthermore, we showed a significant association between malnutrition status and hypoalbuminemia (p<0.001), with a weak positive bilateral correlation between albumin and BMI (r=-0.218; p=0.001). These differences were also examined using analysis of variance (ANOVA), which showed a statistically significant difference in albumin levels between groups with and without malnutrition (p<0.001) and between groups with normal and elevated CRP levels (p<0.001). The ANOVA test isolated a significant difference between the four groups: active disease/malnutrition, remission/malnutrition, active disease/no malnutrition, and remission/no malnutrition, with respective albumin means in each group as follows: 34.3±4.1; 39±1.15; 38.6±3.1; and 40±3.3 (p<0.001). Multivariate analysis using multiple linear regression showed that malnutrition (p<0.001), disease activity (p=0.012), and elevated CRP (p<0.001) were independently associated with hypoalbuminemia.

Conclusions Serum albumin is an independent marker of both inflammation and malnutrition in patients with IBD, with the lowest levels observed in patients who are both malnourished and have active disease.



Publication History

Article published online:
27 March 2025

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