Prevalence and Impact of Zinc Deficiency on Clinical Outcomes in Inflammatory Bowel Disease

Background: Inflammatory bowel disease (IBD) can lead to zinc deficiency, which plays a critical role in immune function and tissue repair. This study aims to determine the prevalence, clinical characteristics, and impact of zinc deficiency in IBD patients. Methods: This is a retrospective study of patients aged ≥14 years with confirmed IBD and available zinc level measurement. Zinc deficiency was defined as a level <10.6 µmol/L. Primary outcomes included the prevalence of zinc deficiency and the characterization of the clinical profile of patients with zinc deficiency. Secondary outcomes included IBD-related hospitalizations, emergency room visits, surgeries, and complications (anemia, small bowel obstruction, new perianal disease, intra-abdominal abscess). Results: Among 447 patients (54.4% male; 79.2% Crohn's disease) with a median age of 29 years (IQR: 22-38), 45.6% had zinc deficiency (83.8% Crohn's disease). Zinc-deficient patients had higher C-reactive protein and fecal calprotectin (both p < 0.001) levels, and were more likely to be on corticosteroids (p = 0.04). Zinc deficiency was associated with higher rates of IBD-related hospitalizations (48.0% vs. 17.7%), surgeries (19.6% vs. 5.8%), complications (30.4% vs. 12.4%), and emergency room visits (40.2% vs. 17.3%) (all p < 0.001). Upon multivariate analysis, predictors of IBD-related hospitalization were zinc deficiency (OR 2.42, 95% CI 1.07-5.48, p = 0.03) and low albumin (OR 9.03, 95% CI 3.38-24.15, p < 0.001). Zinc deficiency was associated with IBD-related surgeries (OR 5.23, 95% CI 1.27-21.45, p = 0.02) and complications (OR 3.98, 95% CI 1.52-10.41, p = 0.005). Conclusions: Zinc deficiency is prevalent in patients with IBD, associated with a high inflammatory burden, and was linked to worse clinical outcomes after controlling for markers of inflammation.