Abstract Biochemical markers are a non-invasive way of objectively measuring inflammation in ulcerative colitis and can play an adjunctive or primary role in the assessment of disease activity. Aim of this study was to A) evaluate serum levels of some biomarkers “leptin, adiponectin, resistin, and ghrelin” in ulcerative colitis (UC) patients, besides the ordinary inflammatory markers, B) to correlate the results with the disease activity, with the clinical characteristics of the disease C) and to examine the possible interaction between the estimated parameters values. Study was conducted on 56 UC patients from the Clinic of Internal Medicine Department and Endoscopy Unit of Alzahraa Hospital, Alazhar University, besides 30 healthy subjects served as control group. Results: Mean levels of ESR, CRP, TNF-á, resistin and ghrelin were significantly higher in active UC patients than the control group, while after the courses of treatment 47 patients achieved complete remission (inactive UC) mean values of these biochemical parameter deceased significantly than the original values at the active disease and the values reached nearly the normal ranges. While in patients (9 patients) who did not achieved complete remission, there were moderate decreased serum levels of these biochemical markers but still higher values than the control group and they still have manifestations of active UC. The mean level of leptin was significantly decreased in active UC patients compared to the control group, while after the course of treatment in patients achieved complete remission (inactive UC) the mean value increased significantly (with mean value 10.1 ng/ml). Conclusion: Our data indicate that, the increased plasma resistin, TNF-á and ghrelin levels correlated with activity of ulcerative colitis and so they could predict the response to therapy and possibly reflect an acute-phase response due to inflammation more than the ordinary inflammatory markers. Resistin, TNF-á and ghrelin levels could be considered as an independent predictor of disease activity in patients with UC and may represent link between inflammation and UC. [Journal of American Science 2010; 6(6):146-155]. (ISSN: 1545-1003).