Serum Fetuin A and Secreted Phosphoprotein 24 as Diagnostic Markers in Inflammatory Bowel Disease

Abstract

Purpose: A completely satisfactory biomarker has yet to be identified for the diagnosis and characterization of inflammatory bowel disease (IBD). This study evaluated the utility of fetuin A and secreted phosphoprotein 24 kDa (Spp24) as novel biomarkers in IBD. Methods: Ninety IBD patients, 54 with ulcerative colitis (UC) and 36 with Crohn's disease (CD), and 41 healthy controls (HC) were included. Serum fetuin A, Spp24, TNF-alpha, and IFN-gamma levels were analyzed by ELISA. Serum C-reactive protein (CRP) levels were determined turbidimetrically by an automated procedure. Results: There were no significant differences in serum Spp24 levels among the UC (17.15 pg/mL, mean), CD (18.88 pg/mL), and HC (14.77 pg/mL) groups (P>0.05). Median fetuin A levels were significantly lower in the UC (249 mg/L) and CD (254 mg/L) groups compared to HC (352 mg/L) (UC vs. HC P<0.001, CD vs. HC P<0.001). Fetuin A levels were not associated with disease activity, extent, or localization in UC or CD. In ROC curve analysis, a fetuin A cut-off value of 304 mg/L predicted IBD with better area under curve, sensitivity, and specificity (0.770, 76.1%, and 70.0%, respectively) compared to CRP (0.645, 32.2%, and 90.2%, respectively). TNF-alpha levels in IBD patients were not differ compared to HC (P>0.05), whereas IFN-gamma levels were statistically significant between UC (3.94 pg/mL, median) and HC (2.65 pg/mL) groups (P=0.037). Conclusion: Fetuin A may have an anti-inflammatory function in IBD and may be used as a potential biomarker for the discrimination of IBD patients from healthy individuals.