Decreased serum iron concentration and total iron binding capacity are associated with serious Crohn\u2019s disease

Jingling Su,Jianlin Ren,Lupeng Liu,Chenxi Xie,Yiqun Hu,Huaxiu Shi,Yandan Ren

doi:10.1038/s41598-022-07948-0

Jingling Su, Jianlin Ren + Show 5 more

Open Access

https://doi.org/10.1038/s41598-022-07948-0

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Abstract

This study aimed to investigate whether serum indicators related to iron stores in the body are associated with clinical and endoscopic disease severity. Eighty-four patients with Crohn’s disease (CD) and twenty-four healthy volunteers were included. The indicators related to iron stores were detected within one week after endoscopic and CT enterography examinations. Patients were divided into three groups according to the CDAI(Crohn's disease activity index)scores. Serum iron levels were decreased in all groups (p < 0.05), and the values of remission group were higher than those of moderate group (p < 0.001). The total iron binding capacity(TIBC)values of the moderate group were lower than those of the controls and the other groups (p < 0.05). None of the indicators differed significantly among the patients classified by SES-CD (p > 0.05). Underweight, decreased serum iron and TIBC were independent risk factors for moderate clinical disease. Combined detection of decreased serum iron and TIBC was helpful in differentiating severe patients. The sensitivity and specificity were 32.7% and 100%, respectively (AUC = 0.812, p < 0.01). Decreases in serum iron and TIBC were associated with the clinical activity of CD. Combined detection of the two indicators was conducive to screening serious disease.

Highlights

This study aimed to investigate whether serum indicators related to iron stores in the body are associated with clinical and endoscopic disease severity
We found that serum iron, total iron binding capacity (TIBC) and transferrin were significantly decreased in patients with moderate clinical disease, but the differences were not significant between the mild and remission groups
The results showed that underweight, decreased serum iron and TIBC were independent risk factors for serious disease

Summary

Introduction

This study aimed to investigate whether serum indicators related to iron stores in the body are associated with clinical and endoscopic disease severity. Abbreviations CD Crohn’s disease CDAI Crohn’s disease activity index SES-CD Simple endoscopic score of Crohn’s CTE CT enterography DcytB Duodenal cytochrome B DMT1 Divalent metal transporter 1 DC Dendritic cell SI Serum iron TIBC Total iron binding capacity Tf Transferrin TSAT Transferrin saturation BMI Body mass index disease. Content in enterocytes reduces the expression of duodenal cytochrome B (DcytB) and divalent metal transporter 1 (DMTI) on the brush border membrane, inhibiting dietary iron absorption[9]. Another important source of hepcidin is dendritic cells (DCs) in the g ut[10]. Basseri RJ et al found that serum hepcidin was positively correlated with IL-6 and negatively correlated with hemoglobin in anemia of chronic disease (ACD)[11].This suggested that iron stored in these inflammatory cells is an important source of hematopoiesis in CD patients with ACD

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