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The aim of this study is to study the characteristics of the fatty acid composition of erythrocyte membranes and blood serum in patients with IBD associated with the stage of the disease, followed by the determination of biomarkers that are significant for determining the activity of IBD.
Materials and methods
We examined 109 patients (mean age 37.7 ± 11.7 years, 59 women, 50 men) with IBD and 53 examined comparison groups (mean age 43.3 ± 11.7 years). The group of patients with IBD included patients with ulcerative colitis - 50 people, with Crohn's disease - 41 people and 18 patients with unclassified colitis. 36 patients were examined in dynamics during the year. Taking into account the dynamics, 109 cases of exacerbation of IBD and 36 cases of disease remission were identified. The study of the composition of fatty acids Er and SA was carried out using a GC / MS system based on three Agilent 7000B quadrupoles (USA).
Results.
In patients with IBD, an increase in the content of saturated fatty acids (mainly due to palmitic, stearic fatty acids) during the period of exacerbation of the disease compared with healthy individuals was revealed, followed by a decrease in the onset of remission (p <0.05). The total content of unsaturated fatty acids is significantly lower in patients with IBD in the exacerbation stage compared to the control group (mainly due to monounsaturated, omega-6 polyunsaturated fatty acids) with an increase in the percentage in patients with inactive disease status (p <0.0001- 0.05). Saturated / unsaturated, saturated / polyunsaturated, omega3 / omega6 PUFA ratios are higher in patients with acute IBD; there was a decrease in the levels of ratios in patients in remission (p<0.05). Revealed inverse correlations of the total content of unsaturated, mono -, polyunsaturated, omega-6 PUFAs with markers of inflammation; associations of the total content of saturated FAs and individual FAs of this class (palmitic, stearic, arachidic) were found to be direct. When analyzing using machine learning and ROC analysis, the key biomarkers for distinguishing patients in the acute stage from healthy individuals were the levels of the following FAs and their ratios: E C18: 2n-6, E C14:0 / S C14:0, E C17:0 , E C20: 0, E C16:1;7 / S C16:1;7, E C20:2n-6 / S C20:2n-6, E C16:1;9 / S C16:1;9, E C18:3n-3 / S C18: 3n-3, E C16:1;9 (AUC 0.962, sensitivity 0.939, specificity 0.888, diagnostic accuracy 0.919). To differentiate patients in remission from healthy individuals - E C20:0, S C16:2n-6, E C16:1; 9, E C18:0, E total content of saturated fatty acids, E C16: 0, S total content of unsaturated fatty acids, E C18:3n-3 / S C18:3n-3 (AUC 0.979, sensitivity 0.956, specificity 0.962, diagnostic accuracy 0.961). In distinguishing the stages among themselves - E C18:3n-3, S C12:0, S C16: 1;9, E C20:4n-6, E C20:0, E SFA/USFA / S SFA/USFA, E C20:3n-6 / S C20:3n-6, E C16:1; 9, S C22:4n-6, E omega6 / omega3 / S omega6 / omega3, E C18:2n-6 (AUC 0.948, sensitivity 0.954, specificity 1.0, diagnostic accuracy 0.962).
Conclusion.
Fatty acid levels of erythrocyte membranes and serum are promising for determining the stage of disease in patients with IBD.
Keywords:inflammatory bowel disease, stages, diagnostics, fatty acids, erythrocytes, blood serum
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