Lucendo Alfredo J, Arias Ángel, Roncero Óscar, Hervías Daniel, Verdejo Cristina, Naveas-Polo Carmen, Bouhmidi Abdelmouneim, Lorente Rufo, Alcázar Luis Miguel, Salueña Irina, García-Quiñones Julio A, Carrillo-Ramos María Jesús
Department of Gastroenterology, Hospital General de Tomelloso, Tomelloso, Ciudad Real, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Spain.
Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Spain; Research Support Unit, Hospital General La Mancha Centro, Alcázar de San Juan, Spain.
Dig Liver Dis. 2017 Apr;49(4):405-411. doi: 10.1016/j.dld.2016.12.005. Epub 2016 Dec 14.
The prevalence, characteristic and determinants of anemia, at the time of inflammatory bowel disease (IBD) diagnosis have yet to be fully elucidated.
Retrospective cross-sectional study. Analytical data and disease characteristics obtained upon diagnosis of 1278 IBD patients [Crohn's disease/ulcerative colitis (CD/UC): 718/560] were collected.
Anemia was present in 41.2% of patients at diagnosis (47% and 33.8% of CD and UC patients, respectively; p<0.001), being severe in 5.5%. Iron deficiency anemia represented 69.6% of cases, with no differences between CD and UC. Female sex was the strongest risk factor for anemia in both CD and UC (OR 7.11; 95%CI 4.18-12.10 and 6.55; 95%CI 3.39-12.63, respectively), followed by elevated (≥2mg/dL) C-reactive protein (OR 4.08; 95%CI 2.39-6.97 and 4.58; 95%CI 2.26-9.27, respectively). Current smoking was a risk factor for anemia in CD (OR 2.23; 95%CI 1.24-4.02), but a protective one in UC (OR 0.36; 95%CI 0.14-0.92). A penetrating CD behavior increased the risk of anemia (OR 3.34; 95%CI 1.36-8.21); in UC, anemia increased with disease extension (E2+E3) (OR 1.80; 95%CI 1.13-2.86).
Female sex and disease activity are major determinants of anemia at IBD diagnosis. Anemia is associated with disease behavior in CD and with disease extension in UC.
炎症性肠病（IBD）诊断时贫血的患病率、特征及决定因素尚未完全阐明。
回顾性横断面研究。收集了1278例IBD患者（克罗恩病/溃疡性结肠炎[CD/UC]：718/560）诊断时的分析数据及疾病特征。
诊断时41.2%的患者存在贫血（CD和UC患者分别为47%和33.8%；p<0.001），重度贫血占5.5%。缺铁性贫血占病例的69.6%，CD和UC之间无差异。女性是CD和UC中贫血最强的危险因素（OR分别为7.11；95%CI 4.18 - 12.10和6.55；95%CI 3.39 - 12.63），其次是C反应蛋白升高（≥2mg/dL）（OR分别为4.08；95%CI 2.39 - 6.97和4.58；95%CI 2.26 - 9.27）。当前吸烟是CD中贫血的危险因素（OR 2.23；95%CI 1.24 - 4.02），但在UC中是保护因素（OR 0.36；95%CI 0.14 - 0.92）。穿透性CD行为增加贫血风险（OR 3.34；95%CI 1.36 - 8.21）；在UC中，贫血随疾病范围扩大（E2 + E3）而增加（OR 1.80；95%CI 1.13 - 2.86）。
女性和疾病活动是IBD诊断时贫血的主要决定因素。贫血与CD中的疾病行为及UC中的疾病范围扩大有关。
