Inflammatory bowel disease (IBD) is a chronic intestinal inflammatory disorder affecting individuals of all ages. Elderly IBD patients present distinct disease manifestations compared to young counterparts. However, the underlying mechanisms remain elusive. This study employed an exploratory design. First, colitis models were established in young and aged mice. Serum proteomic analysis revealed that serum insulin-like growth factor binding protein 1 (IGFBP1) was significantly upregulated in aged mice with colitis compared to their young counterparts. Subsequently, a cross-sectional, single-center clinical study involving 95 patients with IBD was conducted. IGFBP1 levels in serum and intestinal tissues of these patients were analyzed, focusing on the association of serum IGFBP1 levels with clinical/endoscopic disease activity, and that of intestinal tissue IGFBP1 levels with histological disease activity. IGFBP1 levels in both serum and intestinal tissues were higher in elderly IBD patients than in young IBD patients. Serum IGFBP1 level was negatively correlated with multiple inflammation-related laboratory marker levels in elderly IBD patients. Furthermore, IGFBP1 levels in both serum and intestinal tissues were significantly higher in elderly IBD patients with disease inactivity compared to those with disease activity. Additionally, Receiver operating characteristic (ROC) analysis indicated that serum IGFBP1 could serve as a biomarker for assessing disease activity in elderly IBD patients. IGFBP1 is upregulated in elderly IBD patients and negatively associated with disease activity, indicating its potential as a monitoring biomarker for disease activity in this population. • Elderly IBD patients exhibit elevated IGFBP1 levels in both serum and intestinal tissues compared to young patients. • Serum IGFBP1 levels show negative correlation with inflammatory markers in elderly IBD patients. • IGFBP1 levels are significantly higher in inactive versus active elderly IBD patients. • Serum IGFBP1 demonstrates diagnostic potential for disease activity in elderly IBD.
Yang et al. (2026) studied this question.