Lemann Index for Assessment of Crohn’s disease association with the quality of life, endoscopic disease activity and magnetic resonance indices of activity

Abstract

Background Crohn’s disease (CD) is one of the subtypes of idiopathic inflammatory bowel disease and is characterised by continuing inflammation and progressive gut damage. Despite many scoring indices of CD, there is a lack of more global assessment tools for the evaluation of the total disease impact on the gut. Methods One hundred adult patients with proven CD underwent magnetic resonance enterocolonography (MR-EC), colonoscopy and clinical activity assessment. Patients’ quality of life was assessed by IBDQ. MR-EC was used to evaluate the Magnetic Resonance Index of Activity (MaRIA- global (G)), modified (m)MaRIA-G, Clermont-G and the Lemann Index (LI). The CD Endoscopic Index of Severity (CDEIS) was used to score the endoscopic activity of the disease. Results LI and IBDQ (r = −0.813, p < 0.01) showed a strong negative correlation. IBDQ also demonstrated a strong negative correlation with other MR-EC indices: MaRIA-G, mMaRIA-G and Clermont-G (r = −0.731, r = −0.749, r = −0.726, p = 0.01) respectively. Moreover, there was a moderate correlation between MaRIA-G and CDEIS, also MaRIA-G and LI, respectively (r = 0.698 and r = 0.658, p = 0.01). As well as MaRIA-G and LI, other MR-EC indices mMaRIA-G and Clermont-G showed good correlation with CDEIS (r = 0.580 and r = 0.585, p = 0.01). Conclusion A strong negative correlation between LI and the quality-of-life measured by IBDQ was determined. This correlation was less pronounced when using the MaRIA-G index; therefore, the LI could be more helpful in assessing more global characteristics of the disease, besides the inflammatory activity of the gut.