Journal Article Ahead of print
PubMed: 42157106 DOI: 10.1186/s12876-026-04929-9
Association between iron status and inflammation markers with GDF15 and BMP6 in inflammatory bowel disease: a single center cross-sectional study.
BMC Gastroenterol
Authors: Yusuf Üstün, Sinan Yanık, Fatma Uçar, Ahmet Yalçın Üstün, Harun Erdal, Yusuf Coşkun, İlhami Yüksel
Affiliations
- University of Health Sciences, Dışkapı Yıldırım Beyazıt Education and Research Hospital, Gastroenterology Clinic, Ankara, Turkey.
- Etlik City Hospital, Gastroenterology Clinic, Ankara, Turkey.
- University of Health Sciences, Dışkapı Yıldırım Beyazıt Education and Research Hospital, Gastroenterology Clinic, Ankara, Turkey. Etlik City Hospital, Gastroenterology Clinic, Ankara, Turkey.
- University of Health Sciences, Dışkapı Yıldırım Beyazıt Education and Research Hospital, Gastroenterology Clinic, Ankara, Turkey. Etlik City Hospital, Medical Biochemistry Clinic, Ankara, Turkey.
- Faculty of Medicine, Azerbaijan Medical University, Baku, Azerbaijan.
- University of Health Sciences, Dışkapı Yıldırım Beyazıt Education and Research Hospital, Gastroenterology Clinic, Ankara, Turkey.
- Etlik City Hospital, Gastroenterology Clinic, Ankara, Turkey.
- Bilkent City Hospital, Gastroenterology Clinic, Ankara, Turkey.
Abstract
BACKGROUND
Inflammatory bowel diseases (IBD), including Crohn's disease (CD) and ulcerative colitis (UC), are chronic disorders with relapsing and remitting disease courses. Several clinical indicators and biomarkers have been evaluated for their clinical utility in assessing disease prognosis and monitoring disease activity. This study evaluated the utility of growth differentiation factor-15 (GDF15) and bone morphogenetic protein-6 (BMP6) in inflammatory pathways and iron regulation in IBD.
METHODS
Between September 2015 and March 2016, this single-center, cross-sectional study included 40 CD patients, 29 UC patients, and 70 healthy controls. The disease activity was measured using the Mayo score and the Crohn's Disease Activity Index (CDAI). Serum iron, hematological indices, inflammatory markers, and the novel biomarkers BMP6 and GDF15 as determined by ELISA were evaluated.
RESULTS
Both the CD and UC groups showed significantly lower serum iron (p < 0.001), reduced mean corpuscular hemoglobin concentration, and higher red cell distribution width than the control group. Inflammatory markers, including erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), were elevated in IBD, particularly during active disease, with CRP increasing significantly in active UC compared to remission (p = 0.040). In contrast, BMP6 and GDF15 levels did not differ significantly between the disease groups or activity states. Nonetheless, GDF15 demonstrated moderate positive correlations with serum iron (r = 0.314), hemoglobin (r = 0.320), and mean corpuscular hemoglobin concentration (MCHC) (r = 0.344), suggesting a link to erythropoietic or iron-related processes rather than inflammation.
CONCLUSIONS
Conventional markers reliably confirmed iron deficiency and inflammation in IBD. BMP6 and GDF15 levels did not differ significantly across disease states, indicating limited utility as markers of disease activity. Notably, GDF15 was positively correlated with serum iron, hemoglobin, and MCHC, suggesting its association with iron metabolism rather than active inflammation. Larger longitudinal studies are warranted to validate this potential role.
TRIAL REGISTRATION
Not applicable.
MeSH
Hemoglobins, Cross-Sectional Studies, Serum, Biomarkers, Inflammatory Bowel Diseases, Gastrointestinal Diseases