Herrera-deGuise Claudia, Casellas Francesc, Robles Virginia, Navarro Ester, Borruel Natalia
Unitat Atenció Crohn-Colitis (UACC), Hospital Universitari Vall d'Hebron, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (Ciberehd), Barcelona, Spain.
Inflamm Bowel Dis. 2016 Jun;22(6):1450-5. doi: 10.1097/MIB.0000000000000768.
Anemia is a common complication of inflammatory bowel disease (IBD) and contributes to the deterioration of health-related quality of life (HRQOL). Iron deficiency (ID) is a prevalent underlying factor, present in up to 90% of patients. In the absence of anemia, it is unclear as to what extent ID can affect HRQOL in patients with IBD. Our aim was to determine whether ID without anemia negatively affects normal perception of HRQOL in patients with IBD in remission.
We conducted a prospective, cross-sectional study in patients with IBD in remission without anemia. Blood samples were obtained to determine iron status, and patients completed the Inflammatory Bowel Disease Questionnaire-36. ID was defined on serum ferritin <30 ng/mL and transferrin saturation <16%. Restoration of HRQOL was defined as ≥209 on the Inflammatory Bowel Disease Questionnaire-36.
One hundred-four patients with IBD in clinical remission were included; 45 patients were iron deficient and 59 had normal iron status. All patients were in clinical remission, with a median Harvey-Bradshaw Index ≤0 and Simple Clinical Colitis Activity Index ≤0. Median hemoglobin was 12.8 g/dL in the ID group and 13.9 g/dL in the normal iron status group (P < 0.05). Prevalence of female patients was higher in the ID group (odds ratio, 4.45; 95% CI, 1.7-11.7; P < 0.01). The median global value of Inflammatory Bowel Disease Questionnaire-36 was not different between the groups (219 in the ID group versus 230 in the normal iron status group, P = not significant), but restoration of health was significantly less frequent in patients with ID (odds ratio, 2.83; 95% CI, 1.22-6.6; P < 0.05).
ID in absence of anemia negatively impacts normal perception of HRQOL in patients with IBD in remission. Correction of ID may be a new target in the treatment of these patients.
贫血是炎症性肠病（IBD）的常见并发症，会导致健康相关生活质量（HRQOL）下降。缺铁（ID）是一个普遍存在的潜在因素，在高达90%的患者中存在。在没有贫血的情况下，尚不清楚缺铁在多大程度上会影响IBD患者的HRQOL。我们的目的是确定无贫血的缺铁是否会对缓解期IBD患者的HRQOL正常感知产生负面影响。
我们对缓解期无贫血的IBD患者进行了一项前瞻性横断面研究。采集血样以确定铁状态，患者完成炎症性肠病问卷-36。缺铁定义为血清铁蛋白<30 ng/mL且转铁蛋白饱和度<16%。HRQOL恢复定义为炎症性肠病问卷-36得分≥209。
纳入104例临床缓解的IBD患者；45例缺铁，59例铁状态正常。所有患者均处于临床缓解期，Harvey-Bradshaw指数中位数≤0，简单临床结肠炎活动指数≤0。缺铁组血红蛋白中位数为12.8 g/dL，铁状态正常组为13.9 g/dL（P<0.05）。缺铁组女性患者比例更高（比值比，4.45；95%CI，1.7-11.7；P<0.01）。两组炎症性肠病问卷-36的总体中位数无差异（缺铁组为219，铁状态正常组为230，P=无显著性差异），但缺铁患者健康恢复的频率显著更低（比值比，2.83；95%CI，1.22-6.6；P<0.05）。
无贫血的缺铁对缓解期IBD患者的HRQOL正常感知有负面影响。纠正缺铁可能是这些患者治疗的新靶点。
