A study on the changes in serum SGK1 and XBP1 levels and their correlation with prognosis in ulcerative colitis pa-tients with different disease activity levels

Zhang Xi; Xue Lin; Luo Changqin; Sun Jiasen; Wang Zhenzhe

doi:10.3969/j.issn.1671-6450.2025.02.010

Abstract：Objective To investigate the changes in serum levels of serum/glucocorticoid-regulated kinase 1(SGK1)and X-box binding protein 1(XBP1)in ulcerative colitis(UC)patients with varying degrees of disease activity,and to explore their correlation with prognosis.Methods A total of 92 active-phase UC patients and 92 remission-phase UC patients were selected from the Department of Gastroenterology,Ankang Central Hospital,from January 2021 to January 2024.The active-phase UC patients were further divided into mild,moderate,and severe subgroups based on disease activi-ty(24,29,and 39 patients,respectively).According to the 6-month prognosis,patients were categorized into poor prognosis(34 patients)and good prognosis(58 patients)subgroups.Serum SGK1 and XBP1 levels were measured by enzyme-linked immunosorbent assay.The correlation between serum SGK1 and XBP1 levels and prognosis in active-phase UC patients was analyzed using multivariate unconditional logistic regression and ROC curve analysis.Results The serum SGK1 level in the active-phase group was higher than that in the remission-phase group,while the serum XBP1 level was lower in the active-phase group(t/P=11.051/＜0.001,14.639/＜0.001).Among active phase subgroups,SGK1 levels were highest in the severe activity subgroup,followed by the moderate and mild activity subgroups,while XBP1 levels were lowest in the se-vere activity subgroup,followed by the moderate and mild activity subgroups(F/P=215.932/＜0.001,269.335/＜0.001).The unfavorable prognosis rate among active phase UC patients was 36.96％(34/92).Compared with the favorable prognosis subgroup,the unfavorable prognosis subgroup exhibited higher disease severity and SGK1 levels,and lower XBP1 levels(x2/t/P=4.852/＜0.001,5.689/＜0.001,5.077/＜0.001).Severe disease activity and elevated SGK1 were independent risk factors for unfavorable prognosis in active phase UC,while elevated XBP1 was an independent protective factor[OR(95％CI)=4.929(1.756 to 13.833),1.147(1.053 to 1250),0.783(0.677 to 0.905)].The area under the curve(AUC)for predicting unfavor-able prognosis in active phase UC was 0.795 for SGK1,0.792 for XBP1,and 0.881 for the combined model of SGK1 and XBP1.The combined model showed significantly better predictive efficacy than SGK1 or XBP1 alone(Z/P=2.122/0.034,2.382/0.017).Conclusion Elevated serum SGK1 levels and decreased XBP1 levels in UC patients are associated with in-creased disease activity and poor prognosis.The combined prediction of prognosis using both SGK1 and XBP1 levels has high predictive efficacy in patients with active UC.