A84 high fecal calprotectin levels in ulcerative colitis patients in clinical remission are associated with specific clinical and dietary intake parameters.

Ulcerative colitis (UC) is a debilitating chronic inflammation with frequent relapses. Fecal calprotectin (FCP), a cytosolic protein of mucosal neutrophils, is the most promising non-invasive fecal marker of intestinal inflammation. We have previously shown that UC patients in clinical remission who had FCP>150 µg/g had a significantly higher chance of relapse within the next 12 months. In this study we aimed to investigate which demographic, clinical, laboratory, dietary and lifestyle related factors were associated with high FCP. In this cross-sectional study, FCP was measured using ELISA on samples from adult UC patients who were in clinical remission (Partial Mayo score<3). Demographic (age, gender), clinical (e.g. disease subtype, medication, disease duration), laboratory (e.g. serum vit D, B12, iron status, liver function tests, C-reactive protein), and lifestyle related (e.g. physical activity, smoking, anthropometric measurements) measurements were collected. Health related quality of life was assessed using SIBDQ-10. Assessment of dietary intake during the past twelve months before enrollment in the study was performed using a validated food frequency questionnaire. Residual method was used to calculate energy-adjusted nutrients intake. Seventy-two patients were included in this study (mean age: 40.7 ± 14.1 years, females: 60.7%). Interestingly, 41.0% of UC patients in clinical remission had FCP >150 µg/g, defined as “high FCP”. The prevalence of high FCP in males and females was 54.2 and 32.4%, respectively (P=0.09). After adjusting for gender, age and BMI, patients with high FCP had a significantly higher carbohydrate (233.0 ± 34.8 vs. 214.4 ± 25.1 g/d, P=0.02) intake, but lower consumption of alcohol (2.1 ± 3.8 vs. 4.4 ± 5.1 g/d, P=0.05), monounsaturated (25.7 ± 11.7 vs. 29.3 ± 7.8 g/d, P=0.08), and polyunsaturated fatty acids (12.3 ± 6.5 vs. 14.7 ± 5.5g/d, P=0.06). The prevalence of high FCP in patients who had previous history of proctitis, left-sided colitis, and pancolitis was 0, 38, and 49%, respectively (P=0.02). Serum albumin level was higher in patients with normal FCP than in patients with high FCP (44.8 ± 2.4 vs. 43.2 ± 2.9 g/L, P=0.02). FCP was not related to vitamin D, B12, iron, obesity, physical activity, and quality of life status. Increased fecal calprotectin as a marker of subclinical disease in UC patients is associated with high carbohydrate intake and low consumption of monounsaturated and polyunsaturated fatty acids in male patients with more extensive previous disease. These findings suggest that diet can be a significant determining factor in modulation of inflammation in UC patients who are in clinical remission. Alberta Innovates - Bio Solutions