Iron Deficiency in Patients with Inflammatory Bowel Diseases: A Prospective Multicenter Cross-Sectional Study

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.

Prevalence of iron deficiency in patients admitted to a geriatric unit: a multicenter cross-sectional study

“…Indeed, in older patients, the underlying cause of ID is often multifactorial because several chronic comorbidities are frequently present. In the other CARENFER studies, high ID prevalence was reported in patients with cancer (57.9%) [ 6 ], heart failure (49.6%) [ 7 ], inflammatory bowel diseases (23.7%) [ 9 ] CKD (47.1%) [ 8 ] or preoperatively in patients undergoing major elective surgery (47.0%) [ 36 ]. By using a common definition of ID (serum ferritin < 100 μg/L and/or TSAT < 20%), the prevalence rates for the different chronic conditions were 58.1% in cancer, 62.8% in heart failure, 61.2% in inflammatory bowel disease and 47.1% in CKD [ 26 ].…”

“…ID is common in chronic diseases such as heart failure, chronic kidney disease (CKD) or cancer [ 6 – 9 ]. Independently of anemia, ID is also associated to more rapid clinical worsening in heart failure [ 10 ], non-dialysis CKD [ 11 , 12 ] and cancer [ 13 ] and is a risk factor of mortality in patients with heart failure [ 10 , 14 ] and CKD [ 11 , 12 ].…”

Perioperative Iron Deficiency in Patients Scheduled for Major Elective Surgeries: A French Prospective Multicenter Cross-Sectional Study

“…Comparable prevalence has been reported in the other prospective French CARENFER studies using the same definition of iron deficiency: 58.1% in cancer, 62.8% in chronic heart failure, 61.2% in intestinal bowel disorder, and 47.1% in chronic kidney disease. 16,20–23…”

“…Comparable prevalence has been reported in the other prospective French CARENFER studies using the same definition of iron deficiency: 58.1% in cancer, 62.8% in chronic heart failure, 61.2% in intestinal bowel disorder, and 47.1% in chronic kidney disease. 16,[20][21][22][23] Iron deficiency is often present in the absence of anemia, which is the ultimate stage of iron deficiency. Munoz et al 1 reported iron deficiency in 68.7% of nonanemic and 87% of anemic patients undergoing cardiac surgery.…”

Predicting response to iron supplementation in patients with active inflammatory bowel disease (PRIme): a randomised trial protocol

“…1 2 Anaemia affects approximately one-fifth of adult outpatients with IBD and up to 74% of hospitalised patients or patients with a recent IBD diagnosis. [3][4][5] The burden of anaemia is substantial, as it has been associated with a reduced quality of life (QoL), cognitive performance and socioeconomic participation, increased healthcare costs and risk of hospitalisation. [6][7][8][9] Anaemia in IBD is often multifactorial, but the most common cause is iron deficiency (ID).…”