Prevalence and relevant factors of micronutrient deficiencies in hospitalized patients with inflammatory bowel disease
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Published on: January 5, 2017
Xiaojuan Li1, Yedong Hu1, Xiaodan Shi1
1Department of Gastroenterology, Shanghai East Hospital, Medicine School of Tongji University, Shanghai, China.
Objectives:
Micronutrient deficiencies are common in hospitalized patients with inflammatory bowel disease (IBD). We aimed to investigate the prevalence of micronutrient deficiencies, and explore relevant factors in hospitalized patients with IBD.
Methods:
A total of 52 hospitalized patients with IBD were included. Overall malnutrition and quality of life were evaluated with questionnaires, and micronutrient deficiencies were evaluated with serologic indices. Univariate and bivariate analyses were performed, and regression was applied to explore factors associated with micronutrient deficiencies.
Results:
The most common micronutrient deficiency was 25-hydroxyvitamin D3 (25[OH]D; 76.9%). Folate deficiency was more common in recently diagnosed than in previously diagnosed patients (37.0% vs. 8.0%; P = 0.013), but iron deficiency was the opposite (29.6% vs. 60.0%; P = 0.028). 25(OH)D interacted with folate (rs = 0.292; P = 0.036), vitamin B12 (rs = 0.292; P = 0.035), and calcium (rs = 0.415; P = 0.002), and ferritin interacted with folate (rs = -0.288; P = 0.038) and magnesium (rs = -0.333; P = 0.016). Calcium-deficient patients had longer hospital stays than those with normal calcium levels (P = 0.016). Low 25(OH)D levels increased the risk of overall malnutrition (odds ratio [OR]: 0.866; 95% confidence interval [CI], 0.744-0.982; P = 0.025), and low ferritin and calcium suggested a poorer quality of life (P = 0.043 and 0.011, respectively). In addition, hemoglobin (OR: 0.930; 95% CI, 0.870-0.993; P = 0.034) and folate (OR: 0.708; 95% CI, 0.545-0.922; P = 0.037) were independent protective factors against 25(OH)D deficiency.
Conclusions:
Hospitalized patients with IBD were at risk of multiple micronutrient deficiencies, even those with a recent diagnosis or in remission. There were interactions between micronutrients and nutritional indices. Early identification and correction of micronutrient deficiency, as well as relevant factors, may improve clinical outcomes.
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