Alfredo J Lucendo1, Ángel Arias2, Óscar Roncero3, Daniel Hervías4, Cristina Verdejo5, Carmen Naveas-Polo6, Abdelmouneim Bouhmidi7, Rufo Lorente5, Luis Miguel Alcázar6, Irina Salueña7, Julio A García-Quiñones8, María Jesús Carrillo-Ramos8. 1. Department of Gastroenterology, Hospital General de Tomelloso, Tomelloso, Ciudad Real, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Spain. Electronic address: alucendo@vodafone.es. 2. Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Spain; Research Support Unit, Hospital General La Mancha Centro, Alcázar de San Juan, Spain. 3. Department of Gastroenterology, Hospital General La Mancha Centro, Alcázar de San Juan, Spain. 4. Department of Gastroenterology, Hospital Virgen de Altagracia, Manzanares, Spain. 5. Department of Gastroenterology/IBD Unit, Hospital General Universitario de Ciudad Real, Spain. 6. Department of Gastroenterology, Hospital Gutierrez Ortega, Valdepeñas, Spain. 7. Department of Gastroenterology, Hospital Santa Bárbara, Puertollano, Spain. 8. Department of Gastroenterology, Hospital General de Tomelloso, Tomelloso, Ciudad Real, Spain.
Abstract
BACKGROUND: The prevalence, characteristic and determinants of anemia, at the time of inflammatory bowel disease (IBD) diagnosis have yet to be fully elucidated. METHODS: Retrospective cross-sectional study. Analytical data and disease characteristics obtained upon diagnosis of 1278 IBD patients [Crohn's disease/ulcerative colitis (CD/UC): 718/560] were collected. RESULTS: Anemia was present in 41.2% of patients at diagnosis (47% and 33.8% of CD and UC patients, respectively; p<0.001), being severe in 5.5%. Iron deficiency anemia represented 69.6% of cases, with no differences between CD and UC. Female sex was the strongest risk factor for anemia in both CD and UC (OR 7.11; 95%CI 4.18-12.10 and 6.55; 95%CI 3.39-12.63, respectively), followed by elevated (≥2mg/dL) C-reactive protein (OR 4.08; 95%CI 2.39-6.97 and 4.58; 95%CI 2.26-9.27, respectively). Current smoking was a risk factor for anemia in CD (OR 2.23; 95%CI 1.24-4.02), but a protective one in UC (OR 0.36; 95%CI 0.14-0.92). A penetrating CD behavior increased the risk of anemia (OR 3.34; 95%CI 1.36-8.21); in UC, anemia increased with disease extension (E2+E3) (OR 1.80; 95%CI 1.13-2.86). CONCLUSIONS: Female sex and disease activity are major determinants of anemia at IBD diagnosis. Anemia is associated with disease behavior in CD and with disease extension in UC.
BACKGROUND: The prevalence, characteristic and determinants of anemia, at the time of inflammatory bowel disease (IBD) diagnosis have yet to be fully elucidated. METHODS: Retrospective cross-sectional study. Analytical data and disease characteristics obtained upon diagnosis of 1278 IBD patients [Crohn's disease/ulcerative colitis (CD/UC): 718/560] were collected. RESULTS:Anemia was present in 41.2% of patients at diagnosis (47% and 33.8% of CD and UC patients, respectively; p<0.001), being severe in 5.5%. Iron deficiency anemia represented 69.6% of cases, with no differences between CD and UC. Female sex was the strongest risk factor for anemia in both CD and UC (OR 7.11; 95%CI 4.18-12.10 and 6.55; 95%CI 3.39-12.63, respectively), followed by elevated (≥2mg/dL) C-reactive protein (OR 4.08; 95%CI 2.39-6.97 and 4.58; 95%CI 2.26-9.27, respectively). Current smoking was a risk factor for anemia in CD (OR 2.23; 95%CI 1.24-4.02), but a protective one in UC (OR 0.36; 95%CI 0.14-0.92). A penetrating CD behavior increased the risk of anemia (OR 3.34; 95%CI 1.36-8.21); in UC, anemia increased with disease extension (E2+E3) (OR 1.80; 95%CI 1.13-2.86). CONCLUSIONS: Female sex and disease activity are major determinants of anemia at IBD diagnosis. Anemia is associated with disease behavior in CD and with disease extension in UC.
Authors: Nam Hee Kim; Jung Ho Park; Dong Il Park; Chong Il Sohn; Kyuyong Choi; Yoon Suk Jung Journal: Korean J Intern Med Date: 2018-01-05 Impact factor: 2.884