title: Biomarkers of altered coagulation and fibrinolysis as measures of disease activity in active inflammatory bowel disease: a gender-stratified, cohort analysis.
abstract: BACKGROUND
  Growing evidence recognizes inflammatory bowel disease (IBD) as a chronic inflammatory condition characterized by a hypercoagulable state and prothrombotic conditions. The aims of our study were to evaluate the abnormalities in coagulation and fibrinolysis status in patients with IBD, and to analyze parameters of altered coagulation and fibrinolysis status which can correlated with and predict inflammatory parameters of disease activity.
  
  
  METHODS
  A cohort of 271 consecutive IBD patients was compared with healthy controls for coagulation and fibrinolysis status. Associations between altered coagulation and fibrinolysis status stratified by gender and inflammatory parameters were analyzed.
  
  
  RESULTS
  The mean levels of platelet, platelet distribution width, prothrombin time, fibrinogen, activated partial thromboplastin time were significantly higher in IBD patients than in healthy controls (all P<0.05). Mean platelet volume was lower in male patients with IBD than in healthy controls (P<0.01). Furthermore, multiple linear regression indicated that fibrinogen was an independent predictor of ESR (beta=1.316, P=<0.001) and CRP (beta=1.233, P=0.015) in male patients with active ulcerative colitis. Platelet (beta=0.436, P=0.037) and prothrombin time (beta=0.810, P=<0.001) were predictors of Crohn's Disease Activity Index in female patients with Crohn's disease.
  
  
  CONCLUSIONS
  To our knowledge, this study provides characteristics on altered coagulation and fibrinolysis status in active IBD patients using the largest number of cases assembled in one study to date. Our data suggest that in IBD patients, abnormalities in coagulation and fibrinolysis status were associated with disease activity. Fibrinogen, platelet and prothrombin time were predictors of inflammation.
authors.affiliation: Department of Gastroenterology, Renji Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai Institute of Digestive Disease, Shanghai, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Shen
authors.forename: Zhi Hua
authors.initials: ZH
authors.lastname: Ran
authors.forename: Yao
authors.initials: Y
authors.lastname: Zhang
authors.forename: Qing
authors.initials: Q
authors.lastname: Cai
authors.forename: Hong Min
authors.initials: HM
authors.lastname: Yin
authors.forename: Xiao Tian
authors.initials: XT
authors.lastname: Zhou
authors.forename: Shu Dong
authors.initials: SD
authors.lastname: Xiao
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood*; D001777:Blood Coagulation; D001792:Blood Platelets / Q000166:cytology / Q000276:immunology; D015331:Cohort Studies; D005260:Female; D005340:Fibrinogen / Q000276:immunology / Q000378:metabolism; D005342:Fibrinolysis; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000097:blood* / Q000453:epidemiology / Q000276:immunology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011517:Prothrombin Time; D012737:Sex Factors
chemical_list: D015415:Biomarkers; D005340:Fibrinogen