Laurent Peyrin-Biroulet1,2,3, Guillaume Bouguen4, David Laharie5, Gauthier Pellet5, Guillaume Savoye6, Cyrielle Gilletta7, Christophe Michiels8, Anthony Buisson9, Mathurin Fumery10, Jean-Noël Trochu11, Patrice Cacoub12,13,14. 1. Department of Gastroenterology, University of Lorraine, CHRU-Nancy, 54000, Nancy, France. 2. University of Lorraine, Inserm, NGERE, 54000, Nancy, France. 3. Inserm NGERE and Department of Gastroenterology, Nancy University Hospital, University of Lorraine, 1 Allée du Morvan, 54511, Vandoeuvre-lès-Nancy, France. 4. CIC1414, Institut NUMECAN (Nutrition Metabolism and Cancer), CHU Rennes, Univ Rennes, INSERM, 35000, Rennes, France. 5. Service d'Hépato-gastroentérologie et Oncologie Digestive, CHU de Bordeaux, Hôpital Haut-Lévêque, 33000, Bordeaux, France. 6. INSERM UMR1073, Université de Rouen, Hôpital Universitaire de Rouen, Rouen, France. 7. Department of Pancreatology and Gastroenterology, University Hospital of Toulouse Rangueil, 31059, Toulouse Cedex 9, France. 8. Service d'Hepato-Gastro-Entérologie, CHU Dijon Bourgogne, Dijon, France. 9. Service d'Hépato-Gastroentérologie, Université Clermont Auvergne, Inserm, 3iHP, CHU Clermont-Ferrand, Clermont-Ferrand, France. 10. Department of Gastroenterology, University Hospital of Amiens, and Peritox, University of Picardie, Amiens, France. 11. CHU de Nantes, Nantes, France. 12. Department of Internal Medicine and Clinical Immunology, Groupe Hospitalier Pitié-Salpêtrière, AP-HP, 83 Boulevard de l'Hôpital, 75651, Paris, Cedex 13, France. patrice.cacoub@aphp.fr. 13. Immunology-Immunopathology- Immunotherapy (I3), Sorbonne Universités, UPMC Univ Paris 06, INSERM, UMR S 959, Paris, France. patrice.cacoub@aphp.fr. 14. Biotherapy (CIC-BTi) and Inflammation-Immunopathology-Biotherapy Department (DHU i2B), Hôpital Pitié-Salpêtrière, AP-HP, Paris, France. patrice.cacoub@aphp.fr.
Abstract
BACKGROUND: Iron deficiency (ID) is a frequent condition in patients with inflammatory bowel disease (IBD). AIM: Our aim was to investigate the prevalence of ID in patients with IBD. METHODS: This was a prospective multicenter cross-sectional study conducted in 21 gastroenterology departments in France between January and March 2020. All adult patients with confirmed IBD who were admitted to the hospital were eligible for inclusion. ID was defined as ferritinemia ≤ 100 μg/L in patients with signs of inflammation (C-reactive protein (CRP) ≥ 5 mg/L) or ferritinemia < 30 μg/L in the absence of inflammation. RESULTS: In total, 1036 IBD (685 Crohn's disease and 351 ulcerative colitis) patients (52.1% women) with a mean age of 41.8 ± 15.5 years were recruited. Approximately half of the patients (504, 51.1%) were in disease remission at the time of enrollment. Systematic monitoring of iron status was performed in 12/21 (57%) participating centers, including measurements of ferritin (12/12, 100%), hemoglobin (11/12, 92%), transferrin saturation (TSAT) (6/12, 50.0%), and serum iron (5/12, 42%). About one-fifth of the patients had been treated with intravenous iron (218, 21.0%), whereas only a small percentage received oral iron (36, 3.5%). ID occurred in 97 patients (23.7% CI 95% 19.8-28.1). Patients with moderate/severe IBD activity (OR: 3.66; CI 95% 24.4-61.2; p = 0.007) or concomitant anemia (OR: 3.66; CI 95% 1.97-6.78; p < 0.001) had an increased likelihood of having ID. CONCLUSION: Patients with moderate/severe IBD activity or concomitant anemia are at increased risk of ID. Early detection and management of ID in patients with IBD is recommended.
BACKGROUND: Iron deficiency (ID) is a frequent condition in patients with inflammatory bowel disease (IBD). AIM: Our aim was to investigate the prevalence of ID in patients with IBD. METHODS: This was a prospective multicenter cross-sectional study conducted in 21 gastroenterology departments in France between January and March 2020. All adult patients with confirmed IBD who were admitted to the hospital were eligible for inclusion. ID was defined as ferritinemia ≤ 100 μg/L in patients with signs of inflammation (C-reactive protein (CRP) ≥ 5 mg/L) or ferritinemia < 30 μg/L in the absence of inflammation. RESULTS: In total, 1036 IBD (685 Crohn's disease and 351 ulcerative colitis) patients (52.1% women) with a mean age of 41.8 ± 15.5 years were recruited. Approximately half of the patients (504, 51.1%) were in disease remission at the time of enrollment. Systematic monitoring of iron status was performed in 12/21 (57%) participating centers, including measurements of ferritin (12/12, 100%), hemoglobin (11/12, 92%), transferrin saturation (TSAT) (6/12, 50.0%), and serum iron (5/12, 42%). About one-fifth of the patients had been treated with intravenous iron (218, 21.0%), whereas only a small percentage received oral iron (36, 3.5%). ID occurred in 97 patients (23.7% CI 95% 19.8-28.1). Patients with moderate/severe IBD activity (OR: 3.66; CI 95% 24.4-61.2; p = 0.007) or concomitant anemia (OR: 3.66; CI 95% 1.97-6.78; p < 0.001) had an increased likelihood of having ID. CONCLUSION: Patients with moderate/severe IBD activity or concomitant anemia are at increased risk of ID. Early detection and management of ID in patients with IBD is recommended.