Predicted pro-inflammatory high-sensitivity C-reactive protein score and inflammatory bowel disease: a cross-sectional study

Background/Aims: The role of pro-inflammatory factors in the pathogenesis of inflammatory bowel diseases (IBD), is not well understood. This study investigated the association between the predicted pro-inflammatory high-sensitivity C-reactive protein (hs-CRP) score and IBD. Methods: This study involved 127 case/non-case pairs matched by age and sex of participants who underwent gastrointestinal endoscopy in Korea. Participants provided comprehensive sociodemographic, lifestyle, and dietary data. We obtained odds ratio (OR) and 95% confidence interval (CI) for IBD prevalence by tertiles of the predicted pro-inflammatory hs-CRP score using multivariable-adjusted logistic regression models at a two-sided p < 0.05. Results: Higher predicted pro-inflammatory hs-CRP score was associated with a higher IBD prevalence; OR (95% CI): 1.00, 0.88 (0.38, 2.07) and 8.11 (2.07, 31.81; p for trend = 0.006). Similar increased trends of IBD prevalence with score increase were observed for men and women. The association was more pronounced for UC prevalence when we separated UC and CD. Compared to the low category, OR (95% CI) were 5.78 (1.29, 25.89) for UC but 1.44 (0.31, 6.69) for CD in the dichoto-mized higher category. The area under the curve for predicted pro-inflammatory hs-CRP score was 0.72 (95% CI: 0.64, 0.81) for UC and 0.68 (95% CI: 0.58, 0.77) for CD, indicating moderate predictive ability. Conclusions: Higher predicted pro-inflammatory hs-CRP score was significantly associated with an increased prevalence of IBD, particularly UC, and could be a valuable indicator for discriminating people at risk of IBD, offering insights into disease aetiology and opportunities for targeted interventions.