Serum AGR2 and TMAO levels and their correlation with gut microbiota in children with inflammatory bowel disease

doi:10.11958/20241934

Abstract

Abstract:

Objective To explore the relationship between serum levels of anterior gradient 2 (AGR2) and trimethylamine N-oxide (TMAO) and gut microbiota in children with inflammatory bowel disease (IBD). Methods A total of 145 IBD children were selected as the observation group, and children were divided into the ulcerative colitis group (64 cases) and the Crohn's disease group (81 cases) according to the disease type. Meanwhile, 140 healthy children underwent physical examination in our hospital were included as the control group. Serum AGR2 and TMAO levels were detected by enzyme-linked immunosorbent assay (ELISA). The disease activity of ulcerative colitis and Crohn's disease were evaluated using the modified Mayo score and the Crohn's Disease Activity Index (CDAI) score, and patients were divided into the active group (75 cases) and the remission group (70 cases) according to the disease activity. Fecal samples were collected for identification and count of intestinal flora. Receiver operating characteristic (ROC) curve was drawn to analyze the diagnostic value of serum AGR2 and TMAO levels in ulcerative colitis and Crohn's disease. The correlation between serum AGR2 and TMAO levels and intestinal flora was analyzed by Pearson test. Logistic regression was used to analyze the relationship between serum AGR2 and TMAO levels and the disease stage of children with IBD. Results The serum AGR2 level was lower in the ulcerative colitis group and the Crohn's disease group than that in the control group, and the serum TMAO level was higher than that in the control group (P<0.05). The areas under the curve (AUC) of serum AGR2 and TMAO levels were 0.835, 0.836 and 0.896 for diagnosis of ulcerative colitis alone and 0.859, 0.864 and 0.964 for diagnosis of Crohn's disease. The serum AGR2 level and numbers of lactobacillus and bifidobacterium were significantly lower in the active group than those in the remission group, and the serum TMAO level and numbers of Escherichia coli, enterococcus, Helicobacter pylori and streptococcus were significantly higher in the active group than those in the remission group (P<0.05). Serum AGR2 levels in IBD children were positively correlated with numbers of lactobacillus and bifidobacterium, and negatively correlated with numbers of Escherichia coli, Enterococcus, Helicobacter pylori and streptococcus (P<0.05). Serum TMAO level was negatively correlated with numbers of lactobacillus and bifidobacterium, and positively correlated with numbers of Escherichia coli, Enterococcus, Helicobacter pylori and streptococcus (P<0.05). The decreased serum AGR2 level and the increased TMAO level were risk factors for the disease progression to active stage in children with IBD (P<0.05). Conclusion The combination of serum AGR2 and TMAO can effectively diagnose ulcerative colitis and Crohn's disease, and it is more valuable in the diagnosis of Crohn's disease. Abnormal expression of both may participate in the progression of IBD disease by affecting changes in gut microbiota structure.

Key words: inflammatory bowel diseases, Crohn disease, colitis, ulcerative, child, anterior gradient 2, trimethylamine N-oxide, gut microbiota

CLC Number:

R725.74

Figures/Tables 9

References 20

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组别	n	AGR2/（ng/L）	TMAO/（μmol/L）
对照组	140	382.75±97.84	4.41±1.12
溃疡性结肠炎组	64	266.24±69.33^a	6.08±1.56^a
克罗恩病组	81	260.81±71.45^a	6.12±1.50^a
F		70.364^＊＊	56.674^＊＊

组别	n	AGR2/（ng/L）	TMAO/（μmol/L）
对照组	140	382.75±97.84	4.41±1.12
溃疡性结肠炎组	64	266.24±69.33^a	6.08±1.56^a
克罗恩病组	81	260.81±71.45^a	6.12±1.50^a
F		70.364^＊＊	56.674^＊＊

指标	敏感度/%	特异度/%	截断值	AUC（95%CI）
AGR2	79.73	72.15	333.33 ng/L	0.835（0.776~0.894）
TMAO	70.38	86.47	5.08 μmol/L	0.836（0.772~0.901）
联合	87.51	82.16		0.896（0.842~0.950）

指标	敏感度/%	特异度/%	截断值	AUC（95%CI）
AGR2	79.73	72.15	333.33 ng/L	0.835（0.776~0.894）
TMAO	70.38	86.47	5.08 μmol/L	0.836（0.772~0.901）
联合	87.51	82.16		0.896（0.842~0.950）

指标	敏感度/%	特异度/%	截断值	AUC（95%CI）
AGR2	88.93	76.43	304.35 ng/L	0.859（0.809~0.908）
TMAO	76.51	85.57	5.29 μmol/L	0.864（0.812~0.917）
联合	90.12	92.12		0.964（0.941~0.988）