Serum homocysteine level was elevated in ulcerative colitis and can be applied as diagnostic biomarker

Objective - To investigate the correlation between serum level of homocysteine (Hcy) and ulcerative colitis (UC) and evaluate its diagnostic performance by pooling the open published data. Methods - The case-control or cohort studies relevant to serum level of Hcy and UC, published in Pubmed, Medline, EMBASE, China Wanfang and CNKI databases, were systematically screened by using the text word of "homocysteine," "hcy," "UC," "inflammatory bowel disease." The standard mean difference (SMD) was pooled through random effect model. The diagnostic sensitivity, specificity and area under the receiver operating characteristic (AUC) curve of serum Hcy for UC were also calculated. Results - Eighteen relevant case-control studies were identified by electronic searching the related databases. The pooled results indicated that the serum levels of Hcy were statical different between UC and healthy controls with SMD = 0.95 (95% CI: 0.87-1.04). The serum levels of Hcy were 14.30 +/- 3.08 (range: 10.10-21.73) and 10.09 +/- 1.57 (range: 6.80-12.47) mu mol/L for UC and healthy controls, respectively, of the included 18 studies. Using serum Hcy as biomarker for UC identification, the diagnostic sensitivity, specificity and AUC were 94.44% (95% CI: 72.71-99.86%), 72.22% (46.52-90.31%) and 0.88 (95% CI: 0.77-0.99, P < 0.05), respectively. Significant publication bias was identified in the present work. Conclusion - Based on the present publications, serum Hcy was elevated in UC cases and can be applied as serological marker for UC diagnosis. However, due to significant publication bias, the diagnostic performance should be further validated by well-designed prospective diagnostic studies.