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Association between serum bilirubin and mucosal healing among Japanese patients with ulcerative colitis: a cross-sectional study

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Abstract

Purpose

Bilirubin is known to have antioxidant effects. Several pieces of evidence regarding association between serum bilirubin and UC exist. Three studies found that serum bilirubin was inversely associated with severity of ulcerative colitis (UC), but no evidence regarding an association between serum bilirubin and mucosal healing (MH) has yet been shown. Thus, we evaluated this issue among Japanese patients with UC.

Methods

The study subjects consisted of 304 Japanese patients with UC. Serum total bilirubin and indirect bilirubin were divided into quartiles on the basis of the distribution of all study subjects (low, moderate, high, and very high). Several endoscope specialists were responsible for evaluating MH, which was defined as a Mayo endoscopic subscore of 0. The information on clinical remission was collected using medical records.

Results

The mean age was 49.9 years, the percentage of male patients was 59.2%, and the percentage of MH was 29.3%. High serum total bilirubin was independently positively associated with MH (OR 2.26 [95%CI 1.13–4.61]. However, after adjustment for confounding factors, the association between total bilirubin and MH disappeared. Very high serum indirect bilirubin was independently positively associated with MH (OR 2.31 [95%CI 1.10–5.00], p for trend = 0.026). No association between bilirubin and clinical remission was found.

Conclusions

Among Japanese patients with UC, serum indirect bilirubin, but not total bilirubin, was significantly positively associated with MH but not clinical remission.

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Data availability

The datasets analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgments

The authors would like to thank the Ehime Clinical Network for Alimentary Diseases study group, Yu Hashimoto, Shogo Kitahata, Kazuhiro Tange, Keitarou Kawasaki, Yuji Mizukami, Masayoshi Uraoka, Naozumi Shibata, Sanae Nakamura, Satoshi Imamine, Masamoto Torisu, Makoto Yano, Aki Hasebe, Harumi Yano, Masato Murakami, Masumi Hino, Kikuchi Keiko and Tomo Kogama for their support.

Code availability

All statistical analyses were performed using SAS software package version 9.4 (SAS Institute Inc., Cary, NC, USA).

Author information

Authors and Affiliations

  1. Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan

    Kana Shiraishi, Masakazu Hanayama & Yoichi Hiasa

  2. Health Services Center, Ehime University, Bunkyo, Matsuyama, Ehime, 790-8577, Japan

    Shinya Furukawa

  3. Department of Internal Medicine, Saiseikai Matsuyama Hospital, Yamanishi, Matsuyama, Ehime, 791-8026, Japan

    Sen Yagi & Hidehiro Murakami

  4. Department of Gastroenterology, Ehime Prefectural Central Hospital, Kasuga, Matsuyama, Ehime, 790-0024, Japan

    Kenichirou Mori & Tomoyuki Ninomiya

  5. Department of Gastroenterology, Sumitomo Besshi Hospital, Oji, Niihama, Ehime, 792-8543, Japan

    Seiyuu Suzuki

  6. Ohashi Clinic participate in Gastro-Enterology and Ano-Proctology, Funaki, Niihama, Ehime, 792-2856, Japan

    Katsuhisa Ohashi

  7. Department of Inflammatory Bowel Diseases and Therapeutics, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan

    Eiji Takeshita

  8. Endoscopy Center, Ehime University Hospital, Shitsukawa, Toon, Ehime, 791-0295, Japan

    Yoshio Ikeda

Authors
  1. Kana Shiraishi
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  2. Shinya Furukawa
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  3. Sen Yagi
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  4. Masakazu Hanayama
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  6. Tomoyuki Ninomiya
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  7. Seiyuu Suzuki
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  8. Katsuhisa Ohashi
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  9. Hidehiro Murakami
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  10. Eiji Takeshita
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  11. Yoshio Ikeda
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  12. Yoichi Hiasa
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Contributions

Yoichi Hiasa contributed to the study conception and design. Material preparation and data collection were performed by Kana Shiraishi, Shinya Furukawa, Sen Yagi, Masakzu Hanayama, Kenichirou Mori, Tomoyuki Ninomiya, Yuji Mizukami, Seiyuu Suzuki, Katsuhisa Ohashi, Hidehiro Murakami, Eiji Takeshita, and Yoshio Ikeda. Data analysis was performed by Shiraishi Kana and Shinya Furukawa. The first draft of the manuscript was written by Kana Shiraishi and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Shinya Furukawa.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethics approval

This research was approved by the institutional review board of the Ehime University Graduate School of Medicine (#1505011).

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Informed consent was obtained from all individual participants included in the study.

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The participant has consented to the submission of the case report to the journal.

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Shiraishi, K., Furukawa, S., Yagi, S. et al. Association between serum bilirubin and mucosal healing among Japanese patients with ulcerative colitis: a cross-sectional study. Int J Colorectal Dis 36, 377–382 (2021). https://doi.org/10.1007/s00384-020-03774-w

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