High-sensitive C-Reactive Protein as a Marker for Inflammation in Irritable Bowel Syndrome.
BACKGROUND
Recent studies demonstrated low-grade inflammation in patients with irritable bowel syndrome (IBS). However, these studies have been relatively small and do not enable examination of this factor in different subtypes of IBS and the possibility of confounding effects of comorbidities that may be associated with inflammatory responses.


OBJECTIVE
To investigate the association between high-sensitive C-reactive protein (hs-CRP) and the diagnosis of IBS, IBS subtypes, symptoms' severity, and IBS-associated comorbidities.


METHODS
This cross-sectional study uses data from a large matched case-control study of IBS subjects and healthy controls (HC). hs-CRP levels were measured in all subjects. IBS diagnosis was determined by Rome III criteria, negative screening blood tests, and normal colonoscopy. Subjects were evaluated for IBS severity and associated pain and psychological comorbidities.


RESULTS
A total of 242 IBS patients and 244 HC were studied. Median hs-CRP levels in the IBS group were significantly higher than in HC (1.80; interquartile range, 0.7 to 4.04 mg/L vs. 1.20, interquartile range, 0.5 to 2.97 mg/L respectively, P<0.006). Levels were highest in IBS-D patients with greater disease severity. Hs-CRP levels mildly correlated with symptoms severity (r=0.169, P=0.009); this correlation was stronger for the IBS-D patients (r=0.27, P=0.006). IBS was a significant independent predictor (P=0.025) for higher hs-CRP levels, whereas other pain and psychological comorbidities were not.


CONCLUSIONS
Given these observations of cross-sectional differences in hs-CRP between IBS subtypes and severity, independent of pain and comorbidities, more research is needed to explore a possible role of low-grade inflammation in the pathogenesis and/or clinical presentation of IBS.
Departments of *Epidemiology and Preventive Medicine, School of Public Health §Gastroenterology and Liver Diseases, Tel Aviv Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel Departments of †Medicine, Division of Gastroenterology and Hepatology ‡Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC.
Keren
K
Hod
Tamar
T
Ringel-Kulka
Christopher F
CF
Martin
Nitsan
N
Maharshak
Yehuda
Y
Ringel
D000328:Adult; D001007:Anxiety / Q000097:blood / Q000453:epidemiology; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism*; D016022:Case-Control Studies; D015897:Comorbidity; D003248:Constipation / Q000097:blood / Q000209:etiology; D003430:Cross-Sectional Studies; D003863:Depression / Q000097:blood / Q000453:epidemiology; D003967:Diarrhea / Q000097:blood / Q000209:etiology; D015673:Fatigue Syndrome, Chronic / Q000097:blood / Q000453:epidemiology; D005260:Female; D005356:Fibromyalgia / Q000097:blood / Q000453:epidemiology; D006801:Humans; D007249:Inflammation / Q000097:blood; D043183:Irritable Bowel Syndrome / Q000097:blood* / Q000150:complications / Q000453:epidemiology*; D008297:Male; D001523:Mental Disorders / Q000097:blood / Q000453:epidemiology*; D008875:Middle Aged; D008881:Migraine Disorders / Q000097:blood / Q000453:epidemiology; D009135:Muscular Diseases / Q000097:blood / Q000453:epidemiology*; D017699:Pelvic Pain / Q000097:blood / Q000453:epidemiology; D015995:Prevalence; D012720:Severity of Illness Index; D013001:Somatoform Disorders / Q000097:blood / Q000453:epidemiology; D063189:Symptom Assessment; D013706:Temporomandibular Joint Dysfunction Syndrome / Q000097:blood / Q000453:epidemiology; D055815:Young Adult
D015415:Biomarkers; D002097:C-Reactive Protein