Journal
INFLAMMATORY BOWEL DISEASES
Volume 18, Issue 10, Pages 1872-1884Publisher
OXFORD UNIV PRESS INC
DOI: 10.1002/ibd.22862
Keywords
inflammatory bowel disease; Crohn's disease (CD); ulcerative colitis (UC); anti-glycan; serological biomarkers; meta-analysis; systemic review; disease complication; surgery for IBD
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Funding
- NIH/NIDDK [R21 DK077064]
- International Organization for Study of Inflammatory Bowel Disease (IOIBD)
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Background: Anti-glycan antibody serologic markers may serve as a useful adjunct in the diagnosis/prognosis of inflammatory bowel disease (IBD), including Crohn's disease (CD) and ulcerative colitis (UC). This meta-analysis/systemic review aimed to evaluate the diagnostic value, as well as the association of anti-glycan biomarkers with IBD susceptible gene variants, disease complications, and the need for surgery in IBD. Methods: The diagnostic odds ratio (DOR), 95% confidence interval (CI), and sensitivity/specificity were used to compare the diagnostic value of individual and combinations of anti-glycan markers and their association with disease course (complication and/or need for surgery). Results: Fourteen studies were included in the systemic review and nine in the meta-analysis. Individually, anti-Saccharomyces cervisiae antibodies (ASCA) had the highest DOR for differentiating IBD from healthy (DOR 21.1; 1.8247.3; two studies), and CD from UC (DOR 10.2; CI 7.713.7; seven studies). For combination of =2 markers, the DOR was 2.8 (CI 2.23.6; two studies) for CD-related surgery, higher than any individual marker, while the DOR for differentiating CD from UC was 10.2 (CI 5.618.5; three studies) and for complication was 2.8 (CI 2.23.7; two studies), similar to individual markers. Conclusions: ASCA had the highest diagnostic value among individual anti-glycan markers. While anti-chitobioside carbohydrate antibody (ACCA) had the highest association with complications, ASCA and ACCA associated equally with the need for surgery. Although in most individual studies the combination of =2 markers had a better diagnostic value as well as higher association with complications and need for surgery, we found the combination performing slightly better than any individual marker in our meta-analysis. (Inflamm Bowel Dis 2012)
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