Modified Glasgow Prognostic Score as a dual biomarker for disease activity and malnutrition in inflammatory bowel disease

The modified Glasgow Prognostic Score (mGPS) combines C-reactive protein and albumin levels to assess systemic inflammation and nutritional status. We evaluated mGPS as a combined marker associated with disease activity and malnutrition in inflammatory bowel disease (IBD) patients. This cross-sectional study included 286 IBD patients (175 Crohn’s disease, 109 ulcerative colitis) from a tertiary referral center. Disease activity was assessed using validated clinical indices. Nutritional status was evaluated using 7-point Subjective Global Assessment (SGA). mGPS was calculated as: 0 (CRP < 10 mg/L), 1 (CRP ≥ 10 mg/L, albumin ≥ 3.5 g/dL), or 2 (CRP ≥ 10 mg/L, albumin < 3.5 g/dL). Receiver operating characteristic analysis compared the discriminative performance of mGPS versus individual biomarkers. Overall, 73.8% of patients had mGPS 0, 18.9% had mGPS 1, and 7.3% had mGPS 2. A strong association existed between mGPS and disease activity (p < 0.001), with 80% of mGPS 2 patients having active disease compared to 21% of mGPS 0 patients. Similarly, mGPS was strongly associated with malnutrition (p < 0.001), with 6-fold higher prevalence in mGPS 2 versus mGPS 0 patients (33.3% vs. 5.2%). mGPS demonstrated incrementally higher discriminative performance compared to individual biomarkers for both disease activity (AUC 0.73 vs. 0.66 for CRP alone) and malnutrition (AUC 0.71 vs. 0.64 for CRP alone). In multivariable analysis, mGPS 2 was independently associated with active disease (OR 12.84, 95% CI 3.89–42.37) and malnutrition (OR 7.89, 95% CI 2.65–23.52). mGPS is strongly associated with both disease activity and malnutrition and demonstrates good discriminative performance for identifying patients at higher risk.