Department of Gastroenterology, Shanghai East Hospital, Medicine School of Tongji University, Shanghai, China.
Department of Gastroenterology, Shanghai East Hospital, Medicine School of Tongji University, Shanghai, China.
Nutrition. 2022 Jul-Aug;99-100:111671. doi: 10.1016/j.nut.2022.111671. Epub 2022 Mar 31.
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.
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.
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 (r = 0.292; P = 0.036), vitamin B12 (r = 0.292; P = 0.035), and calcium (r = 0.415; P = 0.002), and ferritin interacted with folate (r = -0.288; P = 0.038) and magnesium (r = -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.
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.
炎症性肠病（IBD）住院患者常存在微量营养素缺乏。本研究旨在调查 IBD 住院患者微量营养素缺乏的流行情况，并探讨相关因素。
纳入 52 例 IBD 住院患者。采用问卷调查评估整体营养状况和生活质量，采用血清学指标评估微量营养素缺乏情况。进行单因素和双因素分析，并应用回归分析探讨与微量营养素缺乏相关的因素。
最常见的微量营养素缺乏是 25-羟维生素 D3（25[OH]D；76.9%）。与既往诊断的患者相比，近期诊断的患者叶酸缺乏更为常见（37.0%比 8.0%；P=0.013），但缺铁相反（29.6%比 60.0%；P=0.028）。25（OH）D 与叶酸（r=0.292；P=0.036）、维生素 B12（r=0.292；P=0.035）和钙（r=0.415；P=0.002）存在交互作用，铁蛋白与叶酸（r=-0.288；P=0.038）和镁（r=-0.333；P=0.016）存在交互作用。与血钙正常者相比，血钙缺乏者的住院时间更长（P=0.016）。低 25（OH）D 水平增加整体营养不良的风险（比值比[OR]：0.866；95%置信区间[CI]：0.744-0.982；P=0.025），低铁蛋白和钙提示生活质量较差（P=0.043 和 0.011）。此外，血红蛋白（OR：0.930；95%CI：0.870-0.993；P=0.034）和叶酸（OR：0.708；95%CI：0.545-0.922；P=0.037）是 25（OH）D 缺乏的独立保护因素。
IBD 住院患者存在多种微量营养素缺乏的风险，即使是近期诊断或缓解期的患者也是如此。微量营养素与营养指标之间存在相互作用。早期识别和纠正微量营养素缺乏及相关因素可能改善临床结局。
