Incidence and risk factors of micronutrient deficiency in patients with IBD and intestinal Beh\xe7et\u2019s disease: folate, vitamin B12, 25-OH-vitamin D, and ferritin

TaeIl Kim,Yong Eun Park,Soo Jung Park,Won Ho Kim,Jae Hee Cheon,Jae Jun Park

doi:10.1186/s12876-021-01609-8

TaeIl Kim, Yong Eun Park

Open Access

https://doi.org/10.1186/s12876-021-01609-8

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Abstract

BackgroundPatients with inflammatory bowel disease (IBD) and intestinal Behçet’s disease (BD) are vulnerable to micronutrient deficiencies due to diarrhea-related gastrointestinal loss and poor dietary intake caused by disease-related anorexia. However, few studies have investigated the incidence and risk factors for micronutrient deficiency.MethodsWe retrospectively analyzed 205 patients with IBD who underwent micronutrient examination, including folate, vitamin B12, 25-OH-vitamin D, and/or ferritin level quantification, with follow-up blood tests conducted 6 months later.ResultsEighty patients (39.0%), who were deficient in any of the four micronutrients, were classified as the deficiency group, and the remaining 125 (61.0%) were classified as the non-deficient group. Compared to those in the non-deficiency group, patients in the deficiency group were much younger, had more Crohn's disease (CD) patients, more patients with a history of bowel operation, and significantly less 5-amino salicylic acid usage. Multivariate analysis revealed that CD and bowel operation were significant independent factors associated with micronutrient deficiency.ConclusionsThe incidence of micronutrient deficiency was high (39.0%). Factors including CD, bowel operation, and younger ages were found to be associated with higher risks of deficiency. Therefore, patients with IBD, especially young patients with CD who have undergone bowel resection surgery, need more attention paid to micronutrition.

Highlights

Patients with inflammatory bowel disease (IBD) and intestinal Behçet’s disease (BD) are vulnerable to micronutrient deficiencies due to diarrhea-related gastrointestinal loss and poor dietary intake caused by diseaserelated anorexia
25-OH-vitamin D was quantified in 90.2% of patients, and vitamin B12, folate and ferritin testings were performed for 47.3–62.4% of patients
The proportions of folate (80.0% vs. 50.4%; P < 0.001), vitamin B12 (80.0% vs. 51.2%; P < 0.001), and ferritin tests (60.0% vs. 39.2%; P = 0.004) were significantly higher in the micronutrient deficiency group while 25-OH-vitamin D test was lower than the non-deficiency group (83.8% vs. 94.4%; P = 0.013)

Summary

Introduction

Patients with inflammatory bowel disease (IBD) and intestinal Behçet’s disease (BD) are vulnerable to micronutrient deficiencies due to diarrhea-related gastrointestinal loss and poor dietary intake caused by diseaserelated anorexia. Inflammatory bowel disease (IBD), including Crohn’s disease (CD) and ulcerative colitis (UC), is a chronic disease of the gastrointestinal (GI) tract associated with unclear etiology, leading to rectal bleeding, abdominal pain, and weight loss and repeated cycles of relapse and remission [1, 2]. There is increasing interest in patient management and nutritional status in intestinal BD as well as IBD. Nutrients can be classified as either macronutrients or micronutrients. Macronutrients are energy-providing nutrients including carbohydrates, lipids, and proteins. Micronutrients, including minerals, vitamins, and trace elements, are often deficient in patients with mild disease activity or remission status [9, 10]

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