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Background and Aims: Evaluating disease activity is important in ulcerative colitis. Laboratory markers should be a non-invasive alternative to endoscopy for patients. The objective of our study was to scrutinize the correlation between C-reactive protein (CRP) levels and clinical and endoscopic activity in ulcerative colitis patients., Materials and Methods: We conducted a prospective study between January 2007 and December 2009. In the study we chose consecutive patients of our department with ulcerative colitis. All patients received a standardized questionnaire, clinical examination, and colonoscopy. Based on clinical and endoscopic data, we calculated the disease activity index (DAI) and the Rachmilewitz score., Results: One-hundred and one patients were included. At the time of inclusion, 67 patients had an active disease and 34 patients were in remission. The mean DAI was 6.9 (1-12). The mean Rachmilewitz score was 4.7 (0-12). The median CRP rate was 20.2 ± 24.5 mg/l (1-107 mg/l). An increased CRP was found in 46 patients (46%). An increased CRP level was observed in patients with active disease (P < 0.0001). The DAI was higher in patients with increased CRP (9.5 ± 1.6 vs. 4.7 ± 3.6; P < 0.0001). The Rachmilewitz score was also higher in patients with increased CRP (7.2 ± 2.3 vs. 2.7 ± 3.2; P < 0.0001). A statistically significant association was found between the CRP and the DAI (r = 0.51, P < 0.0001) and between the CRP and the Rachmilewitz score (r = 0.46, P < 0.0001). The optimum cut-off of CRP level that separates active or inactive disease was calculated to be 10 ml/l, with AUC estimated at 0.81 ± 0.04 (95%CI: 0.72-0.88), a sensitivity of 67.1 (95%CI: 54.6-78.1) and a specificity of 97% (95%CI: 84.6-99.5)., Conclusion: Levels of CRP are correlated to clinical and endoscopic activity in ulcerative colitis patients.

Abstract: Background and aims: The role of hyperhomocysteinemia (HHC) and its determinants in Crohn''s disease (CD) remain uncertain. This study was aimed to determine the prevalence of HHC and its main risk factors in Tunisian patients with CD. Methods: This study included 89 patients with CD and 103 age- and sex-matched healthy subjects. Fasting venous blood was collected in all subjects allowing the assessment of homocysteine, folate, vitamin B12, C-reactive protein and creatinine levels. Logistic regression models were applied to identify factors associated with HHC in CD patients. Results: Plasma homocysteine was higher (13.69±4.84μmol/l vs. 10.77±2.80μmol/l; p <0.01) and HHC was more frequent (31.5% vs. 7.8%; p <0.001) in patients compared with controls. The association between HHC and CD persisted after adjustment for smoking, body mass index and serum folate, vitamin B12, creatinine and C-reactive protein. In patients with CD, multivariate analysis showed that HHC was positively associated with age [multi-adjusted odds-ratio (95% confidence interval): 1.14 (1.06–1.24); p <0.001], active disease [7.54 (1.15–49.3); p =0.03], disease duration >2years [8.69 (1.53–49.3); p =0.02] and inversely related to plasma folate [0.64 (0.48–0.84); p =0.002] and vitamin B12 (0.993 (0.987–0.999); p =0.02]. Conclusion: HHC is common in Tunisian patients with CD and is related to B vitamins deficit, as well as disease activity and duration. Further studies should test the effect of correction of HHC by vitamin B supplementation on progression and complications of CD. [Copyright &y& Elsevier]