P-076 Micronutrient Deficiency in Chilean Inflammatory Bowel Disease Patients

Abstract

In spite of new treatment options for Inflammatory Bowel Disease (IBD), many patients have some deficiency in their nutritional status, including micronutrients. Chronic inflammation, less oral intake (due to dietary restrictions or abdominal pain) and medications may contribute to their deficiency. The aim of this study was to measure levels of micronutrients in IBD patients and investigate their association with diagnosis, disease extension, severity and treatments. We performed an observational study in IBD patients suffering from Ulcerative Colitis (UC) or Crohn's Disease (CD). In all patients, micronutrient measurements were performed including serum iron profile, serum 25OHD (vitamin D), vitamin B12, folates, zinc and copper. At the time of the micronutrient measurement, demographic and clinical characterizations regarding diagnosis, disease activity and medications were registered. We also included the clinical determination of Body Mass Index (BMI), hematocrit, hemoglobin and serum albumin. For statistical analysis, we used frequency and percentage for categorical variables, and for continuous variables, media and standard deviation were calculated. A P value <0.05 was considered as statistically significant. A total of 91 patients with IBD were included, 46 of them with UC, 50 women, with a mean age of 35 years (range: 18–72). In general terms, 39.5% of the patients had at least one micronutrient deficiency, 35.1% 2 deficiencies and 12% 3 or more deficiencies. Iron, zinc, copper and vitamin B12 deficiency was found in 33%, 22%, 11% and 10% of the cohort, respectively. No folates deficiency was found. Low levels of vitamin D were found in 76% of patients: 50.5% with levels ≤20 ng/mL (insufficiency), and 25.3% with levels between 20 and 30 ng/mL (deficiency). Lower levels were found in those who underwent any surgery related to IBD (media 19.1 + 12.3 versus 24.1 + 11.1 ng/mL, P = 0.024). No differences were observed related to the type of IBD (UC 24.2 + 11.8 versus CD 21.3 + 11.4; P = 0.071), disease activity (remission 24.0 S 21.2 versus clinical activity 20.0 + 16.2; P = 0.238) or BMI (normal BMI 24.5 + 11.7 versus high BMI 20.0 + 11.7 versus low BMI 21.8 + 10.3). In this cohort, we found that micronutrient deficiencies are frequent, particularly vitamin D, iron and zinc. Body Mass Index or albumin, 2 classical indicators of nutritional status were not associated to micronutrient deficiency. Finally, due to the impact of micronutrients on many physiological functions, their measurement and/or supplementation should be considered.