Clinical and biochemical factors associated with moderate-to-severe ulcerative colitis: a retrospective case–control study

To explore the influencing factors of ulcerative colitis (UC) in patients and provide a scientific basis for the prevention and control of UC. A retrospective selection of 241 patients diagnosed with ulcerative colitis from January 2020 to December 2024 at the People's Hospital of Xinjiang Uygur Autonomous Region was conducted according to the inclusion criteria. Patients were divided into two groups based on the severity of UC during the active phase: control group (n = 132) and experimental group (n = 109). Univariate analysis of basic patient information was performed, and variables with P < 0.05 were further analyzed using a binary logistic regression model to explore the association with moderate-to-severe UC. In this study involving 241 patients, data from the experimental group (109 cases, age 46.80 ± 13.80) were compared with the control group (132 cases, age 47.71 ± 13.90). Univariate analysis showed that variables such as corticosteroid use, history of hypertension, history of anemia, leukocyte count, red blood cell count, platelet count, neutrophils, lymphocytes, C-reactive protein, erythrocyte sedimentation rate (ESR), total protein, albumin, globulin, albumin/globulin ratio, and direct bilirubin were statistically significant (P < 0.05). Binary logistic regression analysis showed that hypertension (95% CI: 0.053–0.491, P = 0.001), lymphocytes (95% CI: 0.285–0.998, P = 0.049), ESR (95% CI: 1.006–1.060, P = 0.017), and direct bilirubin (95% CI: 0.735–0.988, P = 0.034) were all associated with moderate-to-severe UC. ESR and hypertension were identified as risk factors for moderate-to-severe UC, while lymphocytes and direct bilirubin were protective factors. This retrospective study indicates that hypertension, lymphocytes, ESR, and direct bilirubin are associated with moderate-to-severe UC. Therefore, markers such as ESR, hypertension, lymphocytes, and direct bilirubin can enhance the efficiency of diagnosing moderate-to-severe UC.