Bilirubin statistically accounts for the association between Enterobacterales lineage and Mayo endoscopic score in ulcerative colitis: a cross-sectional associational variable analysis.
- 1Department of Gastroenterology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
- 2Liver Transplantation Center, West China Hospital, Sichuan University, Chengdu, China.
Abstract
Background
Patients with ulcerative colitis (UC) frequently exhibit gut enrichment of Enterobacteriaceae and reduced serum bilirubin levels. However, whether bilirubin statistically accounts for the association between Enterobacteriaceae abundance and UC disease activity remains unclear.Methods
This study enrolled 81 UC patients. The relative abundances of Enterobacterales lineage (Gammaproteobacteria, Enterobacterales, Enterobacteriaceae, and Escherichia-Shigella) were determined by 16S rRNA sequencing, and disease activity was assessed using the Mayo endoscopic score (MES). Total bilirubin (TBIL) and indirect bilirubin (IBIL) were examined as potential associative variables. Associational variable analyses were performed using bootstrap methods with 5,000 resamples, and sensitivity analyses were conducted after adjusting for covariates.Results
The abundances of Enterobacterales lineage were positively correlated with MES (p = 0.34-0.40) and negatively correlated with TBIL and IBIL (p = -0.31 to -0.48). Associational variable analyses showed that bilirubin significantly and partially accounted for these positive associations. In covariate-adjusted models, the associational proportions ranged from 40.8% to 42.3% for TBIL and from 37.2% to 40.0% for IBIL.Conclusion
Bilirubin statistically accounts for approximately 37.2%-42.3% of the association between Enterobacterales lineage abundance and UC disease activity. Owing to the cross-sectional design, these findings reflect statistical covariation rather than causal effects, and prospective studies are needed to establish temporal direction.
Related
- Pitfalls and challenges in endoscopic assessment of ulcerative colitis.
- Automated assessment of the ulcerative colitis endoscopic index of severity using a multi-task deep learning model
- Diagnostic prediction of ulcerative colitis using simplified endoscopic features and blood count-derived indices: a multicenter study
- Deep learning-based assessment of ulcerative colitis activity from full-length endoscopic videos with spatial characterisation and histological correlation
- Bowel Urgency Is More Strongly Associated with Biochemical, Endoscopic, and Histological Disease Activity than Other Clinical Symptoms in Ulcerative Colitis
BibTeX
@article{ren2026bilirubin,
title = {{Bilirubin statistically accounts for the association between Enterobacterales lineage and Mayo endoscopic score in ulcerative colitis: a cross-sectional associational variable analysis.}},
author = {Zhengyu Ren and Junni Ma and Siyao Wang and Pumeng Fu and Ruixue Wang and Kai Liu and Yingchao Li},
journal = {Frontiers in medicine},
year = {2026},
month = oct,
doi = {10.3389/fmed.2026.1946063},
url = {https://europepmc.org/article/MED/42952522},
note = {CC BY},
}
RIS
TY - JOUR
TI - Bilirubin statistically accounts for the association between Enterobacterales lineage and Mayo endoscopic score in ulcerative colitis: a cross-sectional associational variable analysis.
AU - Zhengyu Ren
AU - Junni Ma
AU - Siyao Wang
AU - Pumeng Fu
AU - Ruixue Wang
AU - Kai Liu
AU - Yingchao Li
PY - 2026
DA - 2026/10/14
JO - Frontiers in medicine
DO - 10.3389/fmed.2026.1946063
UR - https://europepmc.org/article/MED/42952522
AB - Background Patients with ulcerative colitis (UC) frequently exhibit gut enrichment of Enterobacteriaceae and reduced serum bilirubin levels. However, whether bilirubin statistically accounts for the association between Enterobacteriaceae abundance and UC disease activity remains unclear.Methods This study enrolled 81 UC patients. The relative abundances of Enterobacterales lineage (Gammaproteobacteria, Enterobacterales, Enterobacteriaceae, and Escherichia-Shigella) were determined by 16S rRNA sequencing, and disease activity was assessed using the Mayo endoscopic score (MES). Total bilirubin (TBIL) and indirect bilirubin (IBIL) were examined as potential associative variables. Associational variable analyses were performed using bootstrap methods with 5,000 resamples, and sensitivity analyses were conducted after adjusting for covariates.Results The abundances of Enterobacterales lineage were positively correlated with MES (p = 0.34-0.40) and negatively correlated with TBIL and IBIL (p = -0.31 to -0.48). Associational variable analyses showed that bilirubin significantly and partially accounted for these positive associations. In covariate-adjusted models, the associational proportions ranged from 40.8% to 42.3% for TBIL and from 37.2% to 40.0% for IBIL.Conclusion Bilirubin statistically accounts for approximately 37.2%-42.3% of the association between Enterobacterales lineage abundance and UC disease activity. Owing to the cross-sectional design, these findings reflect statistical covariation rather than causal effects, and prospective studies are needed to establish temporal direction.
SN - 2296-858X
ER -