{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T03:00:06Z","timestamp":1777950006740,"version":"3.51.4"},"reference-count":53,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T00:00:00Z","timestamp":1777852800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"TCM Science and Technology Development Plan of Shandong Province","award":["M-2023173"],"award-info":[{"award-number":["M-2023173"]}]},{"name":"National Natural Science Foundation of Shandong Province","award":["ZR2024MH282"],"award-info":[{"award-number":["ZR2024MH282"]}]},{"name":"National Natural Science Foundation of Shandong Province","award":["ZR2025MS1260"],"award-info":[{"award-number":["ZR2025MS1260"]}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82200591"],"award-info":[{"award-number":["82200591"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82270562"],"award-info":[{"award-number":["82270562"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Ulcerative colitis (UC) is a chronic inflammatory bowel disease, and precise evaluation of disease activity is essential for effective management. This study aimed to assess the value of the peripheral-blood neutrophil percentage-to-hemoglobin ratio (NPHR), fibrinogen-to-prealbumin ratio (FPR), and platelet count (PLT) in identifying moderate-to-severe UC and to develop a predictive model for clinical risk stratification.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data from 277 hospitalized UC patients, consecutively admitted to the Department of Gastroenterology at the Affiliated Hospital of Jining Medical University between May 2023 and October 2025, were retrospectively analyzed. Disease activity was classified based on the modified Mayo score into low-activity (remission or mild) and moderate-to-severe groups. Independent predictors were identified using multivariable logistic regression and incorporated into a nomogram. Discrimination and calibration were assessed via receiver operating characteristic (ROC) curves and calibration curves, respectively. Clinical utility was evaluated through decision curve analysis (DCA) and the clinical impact curve (CIC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      NPHR, FPR, and PLT were independent risk factors for moderate-to-severe UC (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05). The areas under the ROC curves for NPHR, FPR, and PLT were 0.823 (95% CI, 0.773\u20130.873), 0.788 (95% CI, 0.733\u20130.842), and 0.746 (95% CI, 0.687\u20130.805), respectively. The calibration curve demonstrated strong agreement with the ideal line. DCA revealed a favorable net benefit within a threshold probability range of 0.16\u20131.0, while CIC confirmed the model\u2019s high clinical utility in the range of 0.30\u20130.90.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>NPHR, FPR, and PLT are independent predictors of moderate-to-severe UC. The combination of these markers enhances predictive accuracy and provides a valuable tool for disease activity assessment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1814784","type":"journal-article","created":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T05:32:10Z","timestamp":1777872730000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["NPHR, FPR, and PLT as predictors of ulcerative colitis severity: a single-center retrospective study in China"],"prefix":"10.3389","volume":"13","author":[{"given":"Shaolei","family":"Yang","sequence":"first","affiliation":[{"name":"Clinical Medical College of Jining Medical University, Jining Medical University","place":["Jining, Shandong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dandan","family":"Liang","sequence":"additional","affiliation":[{"name":"Clinical Medical College of Jining Medical University, Jining Medical University","place":["Jining, Shandong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yufen","family":"Qin","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Affiliated Hospital of Jining Medical University, Jining Medical University","place":["Jining, Shandong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fengxian","family":"Dai","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Affiliated Hospital of Jining Medical University, Jining Medical University","place":["Jining, Shandong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guangxi","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Affiliated Hospital of Jining Medical University, Jining Medical University","place":["Jining, Shandong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fengqin","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Affiliated Hospital of Jining Medical University, Jining Medical University","place":["Jining, Shandong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,4]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"951","DOI":"10.1001\/jama.2023.15389","article-title":"Ulcerative colitis in adults","volume":"330","author":"Gros","year":"2023","journal-title":"JAMA"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"458","DOI":"10.1038\/s41586-025-08940-0","article-title":"Global evolution of inflammatory bowel disease across epidemiologic stages","volume":"642","author":"Hracs","year":"2025","journal-title":"Nature"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1136\/fg.2010.001362","article-title":"Measurement of faecal calprotectin and lactoferrin in inflammatory bowel disease","volume":"2","author":"Lamb","year":"2010","journal-title":"Frontline Gastroenterol"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"881816","DOI":"10.3389\/fphys.2022.881816","article-title":"The value of fecal calprotectin in Clostridioides difficile infection: a systematic review","volume":"13","author":"Wen","year":"2022","journal-title":"Front Physiol"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"892","DOI":"10.1016\/j.tips.2024.08.003","article-title":"Ulcerative colitis: clinical biomarkers, therapeutic targets, and emerging treatments","volume":"45","author":"Wangchuk","year":"2024","journal-title":"Trends Pharmacol Sci"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"321","DOI":"10.1016\/j.jcmgh.2021.03.002","article-title":"Neutrophil extracellular traps in inflammatory bowel disease: pathogenic mechanisms and clinical translation","volume":"12","author":"Drury","year":"2021","journal-title":"Cell Mol Gastroenterol Hepatol"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"472","DOI":"10.1186\/s12876-021-02040-9","article-title":"Predictive value of fibrinogen in identifying inflammatory bowel disease in active stage","volume":"21","author":"Chen","year":"2021","journal-title":"BMC Gastroenterol"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1186\/s12876-024-03305-9","article-title":"Abnormal platelet parameters in inflammatory bowel disease: a systematic review and meta-analysis","volume":"24","author":"Xu","year":"2024","journal-title":"BMC Gastroenterol"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"pbad026","DOI":"10.1093\/pcmedi\/pbad026","article-title":"Prealbumin as a prognostic indicator for hospital readmission of ulcerative colitis patients","volume":"7","author":"Ye","year":"2023","journal-title":"Precis Clin Med"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"33","DOI":"10.3760\/cma.j.cn101480-20240123-00017","article-title":"Chinese clinical practice guideline on the management of ulcerative colitis (2023, Xi\u2019an)","volume":"8","year":"2024","journal-title":"Chin J Inflamm Bowel Dis"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1625","DOI":"10.1056\/NEJM198712243172603","article-title":"Coated oral 5-aminosalicylic acid therapy for mildly to moderately active ulcerative colitis","volume":"317","author":"Schroeder","year":"1987","journal-title":"N Engl J Med"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"535","DOI":"10.1136\/gutjnl-2011-300486","article-title":"Developing an instrument to assess the endoscopic severity of ulcerative colitis: the Ulcerative Colitis Endoscopic Index of Severity (UCEIS)","volume":"61","author":"Travis","year":"2012","journal-title":"Gut"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"1365","DOI":"10.1093\/ecco-jcc\/jjz067","article-title":"DUBLIN [degree of ulcerative colitis burden of luminal inflammation] score, a simple method to quantify inflammatory burden in ulcerative colitis","volume":"13","author":"Rowan","year":"2019","journal-title":"J Crohns Colitis"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"264","DOI":"10.1093\/cei\/uxae057","article-title":"The neutrophil extracellular traps in neurological diseases: an update","volume":"218","author":"Yu","year":"2024","journal-title":"Clin Exp Immunol"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"1257","DOI":"10.1016\/j.jcmgh.2022.09.002","article-title":"Neutrophil\u2013epithelial crosstalk during intestinal inflammation","volume":"14","author":"Kang","year":"2022","journal-title":"Cell Mol Gastroenterol Hepatol"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"1412","DOI":"10.1136\/gutjnl-2014-307477","article-title":"Comparing histological activity indexes in UC","volume":"64","author":"Bressenot","year":"2015","journal-title":"Gut"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"2510","DOI":"10.1016\/j.cgh.2019.12.011","article-title":"Complete resolution of mucosal neutrophils associates with improved long-term clinical outcomes of patients with ulcerative colitis","volume":"18","author":"Pai","year":"2020","journal-title":"Clin Gastroenterol Hepatol"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"1931","DOI":"10.1093\/ecco-jcc\/jjad110","article-title":"Neutrophil-only histological assessment of ulcerative colitis correlates with endoscopic activity and predicts long-term outcomes in a multicentre study","volume":"17","author":"Parigi","year":"2023","journal-title":"J Crohns Colitis"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1038\/s41423-021-00832-3","article-title":"Neutrophils in chronic inflammatory diseases","volume":"19","author":"Herrero-Cervera","year":"2022","journal-title":"Cell Mol Immunol"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"387","DOI":"10.1016\/j.psym.2020.10.002","article-title":"Cognitive impairment in adult inflammatory bowel disease: a systematic review and meta-analysis","volume":"62","author":"Hopkins","year":"2021","journal-title":"J Acad Consult Liaison Psychiatry"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"4008","DOI":"10.3390\/nu13114008","article-title":"Iron deficiency anemia in inflammatory bowel diseases\u2014a narrative review","volume":"13","author":"Mahadea","year":"2021","journal-title":"Nutrients"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"2175","DOI":"10.2147\/IJGM.S409869","article-title":"Application of monocyte-to-albumin ratio and neutrophil percentage-to-hemoglobin ratio on distinguishing non-small cell lung cancer patients from healthy subjects","volume":"16","author":"Zhao","year":"2023","journal-title":"Int J Gen Med."},{"key":"ref23","doi-asserted-by":"publisher","first-page":"131","DOI":"10.3969\/j.issn.1007-5410.2024.02.007","article-title":"Effect of neutrophil percentage\/hemoglobin ratio on 1-year all-cause mortality of patients with severe chronic heart failure","volume":"29","author":"Wang","year":"2024","journal-title":"Chin J Cardiovasc Med"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"17","DOI":"10.3969\/j.issn.1007-5062.2025.01.003","article-title":"The effect of neutrophil percentage\/hemoglobin ratio on short-term and long-term mortality in critically ill patients with atrial fibrillation","volume":"44","author":"Hu","year":"2025","journal-title":"J Cardiovas Pulm Dis"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"3005","DOI":"10.1016\/j.jtha.2023.08.014","article-title":"Fibrinogen and fibrin: synthesis, structure, and function in health and disease","volume":"21","author":"Wolberg","year":"2023","journal-title":"J Thromb Haemost"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"511","DOI":"10.1182\/blood-2018-07-818211","article-title":"The multifaceted role of fibrinogen in tissue injury and inflammation","volume":"133","author":"Luyendyk","year":"2019","journal-title":"Blood"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"390","DOI":"10.3390\/antiox14040390","article-title":"Fibrinogen oxidation and thrombosis: shaping structure and function","volume":"14","author":"Nencini","year":"2025","journal-title":"Antioxidants"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"e0322789","DOI":"10.1371\/journal.pone.0322789","article-title":"Fibrinogen and colorectal cancer: a study of the Chinese population","volume":"20","author":"Wang","year":"2025","journal-title":"PLoS One"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"1299","DOI":"10.2147\/COPD.S361929","article-title":"Fibrinogen, a promising marker to evaluate severity and prognosis of acute exacerbation of chronic obstructive pulmonary disease: a retrospective observational study","volume":"17","author":"Sun","year":"2022","journal-title":"Int J Chron Obstruct Pulmon Dis"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"1037","DOI":"10.1016\/j.jhep.2023.01.010","article-title":"Haemostasis in cirrhosis: understanding destabilising factors during acute decompensation","volume":"78","author":"Zanetto","year":"2023","journal-title":"J Hepatol"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"1799","DOI":"10.1001\/jama.294.14.1799","article-title":"Plasma fibrinogen level and the risk of major cardiovascular diseases and nonvascular mortality: an individual participant meta-analysis","volume":"294","author":"Danesh","year":"2005","journal-title":"JAMA"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"283","DOI":"10.1038\/nrn.2018.13","article-title":"Fibrinogen in neurological diseases: mechanisms, imaging and therapeutics","volume":"19","author":"Petersen","year":"2018","journal-title":"Nat Rev Neurosci"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"1435236","DOI":"10.3389\/fimmu.2024.1435236","article-title":"Fibrinogen induces inflammatory responses via the immune activating receptor LILRA2","volume":"15","author":"Li","year":"2024","journal-title":"Front Immunol"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"5573","DOI":"10.2147\/IJGM.S477285","article-title":"Fibrinogen, FDP and D-dimer as potential biomarkers for disease severity in ulcerative colitis: a retrospective study","volume":"17","author":"Feng","year":"2024","journal-title":"Int J Gen Med"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"3989","DOI":"10.1038\/s41467-021-24235-0","article-title":"Predicting disease course in ulcerative colitis using stool proteins identified through an aptamer-based screen","volume":"12","author":"Soomro","year":"2021","journal-title":"Nat Commun"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"308","DOI":"10.1016\/j.jjcc.2021.05.009","article-title":"The C-reactive protein to prealbumin ratio on admission and its relationship with outcome in patients hospitalized for acute heart failure","volume":"78","author":"Yamada","year":"2021","journal-title":"J Cardiol"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"639","DOI":"10.1007\/s00520-023-08091-w","article-title":"Changes in serum prealbumin as a marker for nitrogen balance in surgical oncology patients","volume":"31","author":"Hall","year":"2023","journal-title":"Support Care Cancer"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"7569","DOI":"10.1038\/s41598-025-87551-1","article-title":"Investigating the expression of anti\/pro-inflammatory cytokines in the pathogenesis and treatment of ulcerative colitis and its association with serum level of vitamin D","volume":"15","author":"Ahmadi","year":"2025","journal-title":"Sci Rep"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"733","DOI":"10.1056\/nejmra2301594","article-title":"Protein-losing enteropathy","volume":"389","author":"Ozen","year":"2023","journal-title":"N Engl J Med"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"7165","DOI":"10.3390\/jcm12227165","article-title":"Biomarkers for monitoring of changes in disease activity in ulcerative colitis","volume":"12","author":"Tatsumi","year":"2023","journal-title":"J Clin Med"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1186\/s12935-022-02445-w","article-title":"The prognostic value of the fibrinogen to pre-albumin ratio in malignant tumors of the digestive system: a systematic review and meta-analysis","volume":"22","author":"Li","year":"2022","journal-title":"Cancer Cell Int"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"172","DOI":"10.3969\/j.issn.2095-8552.2022.02.015","article-title":"Clinical value of fibrinogen-to-prealbumin ratio and fibrinogen-to-albumin ratio for assessing disease activity in inflammatory bowel disease","volume":"50","author":"Hu","year":"2022","journal-title":"Zhongguo Lin Chuang Yi Shi Za Zhi"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1186\/s12935-022-02532-y","article-title":"Quantification of fibrinogen-to-pre-albumin ratio provides an integrating parameter for differential diagnosis and risk stratification of early-stage colorectal cancer","volume":"22","author":"Ying","year":"2022","journal-title":"Cancer Cell Int"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"381","DOI":"10.1016\/j.jtha.2024.11.016","article-title":"Molecular basis of platelet granule defects","volume":"23","author":"Yao","year":"2025","journal-title":"J Thromb Haemost"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"495","DOI":"10.1038\/s41577-023-00834-4","article-title":"The role of platelets in immune-mediated inflammatory diseases","volume":"23","author":"Scherlinger","year":"2023","journal-title":"Nat Rev Immunol"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"105622","DOI":"10.1016\/j.jbspin.2023.105622","article-title":"Platelets are a major player and represent a therapeutic opportunity in systemic lupus erythematosus","volume":"91","author":"Robert","year":"2024","journal-title":"Joint Bone Spine"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"237","DOI":"10.1038\/s41584-019-0187-9","article-title":"Platelets: emerging facilitators of cellular crosstalk in rheumatoid arthritis","volume":"15","author":"Olumuyiwa-Akeredolu","year":"2019","journal-title":"Nat Rev Rheumatol"},{"key":"ref48","doi-asserted-by":"publisher","first-page":"2633","DOI":"10.3390\/diagnostics12112633","article-title":"Platelet and red blood cell volume indices in patients with rheumatoid arthritis: a systematic review and meta-analysis","volume":"12","author":"Zinellu","year":"2022","journal-title":"Diagnostics"},{"key":"ref49","doi-asserted-by":"publisher","first-page":"28055","DOI":"10.1038\/s41598-024-78462-8","article-title":"Platelet activation through CD62P and the formation of platelet\u2013monocyte complexes are associated with the exacerbation of mucosal inflammation in patients with ulcerative colitis","volume":"14","author":"Sano","year":"2024","journal-title":"Sci Rep"},{"key":"ref50","doi-asserted-by":"publisher","first-page":"1377915","DOI":"10.3389\/fimmu.2024.1377915","article-title":"Platelet indices and inflammatory bowel disease: a Mendelian randomization study","volume":"15","author":"Li","year":"2024","journal-title":"Front Immunol"},{"key":"ref51","doi-asserted-by":"publisher","first-page":"866","DOI":"10.3904\/kjim.2025.118","article-title":"Coagulopathy and platelet abnormalities in patients with inflammatory bowel disease","volume":"40","author":"Kim","year":"2025","journal-title":"Korean J Intern Med"},{"key":"ref52","doi-asserted-by":"publisher","first-page":"765","DOI":"10.1182\/blood.2018893594","article-title":"Platelet hyaluronidase-2 regulates the early stages of inflammatory disease in colitis","volume":"134","author":"Petrey","year":"2019","journal-title":"Blood"},{"key":"ref53","doi-asserted-by":"publisher","first-page":"305","DOI":"10.5604\/17322693.1199305","article-title":"Markers of inflammation, activation of blood platelets and coagulation disorders in inflammatory bowel diseases","volume":"70","author":"Matowicka-Karna","year":"2016","journal-title":"Postepy Hig Med Dosw"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1814784\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T05:32:15Z","timestamp":1777872735000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1814784\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,4]]},"references-count":53,"alternative-id":["10.3389\/fmed.2026.1814784"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1814784","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,4]]},"article-number":"1814784"}}