A prospective analysis of micronutrient status in quiescent inflammatory bowel disease.
Adult
Aged
C-Reactive Protein
/ analysis
Colitis, Ulcerative
/ complications
Crohn Disease
/ complications
Deficiency Diseases
/ diagnosis
Feces
/ chemistry
Female
Humans
Leukocyte L1 Antigen Complex
/ analysis
Male
Micronutrients
/ deficiency
Middle Aged
Nutrition Assessment
Nutritional Status
Predictive Value of Tests
Prevalence
Proportional Hazards Models
Prospective Studies
Recurrence
Remission Induction
Serum Albumin
/ analysis
Time Factors
Young Adult
Inflammatory bowel disease
Micronutrients
Minerals
Nutrition
Trace elements
Vitamins
Journal
Clinical nutrition (Edinburgh, Scotland)
ISSN: 1532-1983
Titre abrégé: Clin Nutr
Pays: England
ID NLM: 8309603
Informations de publication
Date de publication:
01 2021
01 2021
Historique:
received:
22
02
2020
revised:
05
05
2020
accepted:
06
05
2020
pubmed:
11
6
2020
medline:
18
8
2021
entrez:
11
6
2020
Statut:
ppublish
Résumé
ESPEN guidelines advocate patients with inflammatory bowel disease (IBD) have their micronutrient levels checked regularly. This study described the micronutrient status of patients with quiescent IBD and explores whether biochemical micronutrient deficiencies related to time to subsequent disease relapse. Sixteen micronutrients were measured prospectively in blood of patients with IBD in clinical remission [Harvey Bradshaw Index (HBI) ≤4 in Crohn's disease (CD) and a partial Mayo score <2 in ulcerative colitis (UC)]. Patients were followed prospectively using the electronic patient records. The ability of micronutrient status to predict time to relapse was tested with survival analysis and Cox regression. Ninety-three patients were enrolled; Fifty (54%) were also in biochemical remission defined as a normal faecal calprotectin (<250 μg/g), C-reactive protein (<10 mg/L) and serum albumin (>35 g/L). Deficiencies in vitamin D were identified in 27 (29%), zinc in 15 (16%), vitamin B6 in 13 (14%), vitamin C in 12 (13%) and vitamin B12 in 10 (11%). Fewer participants had low serum folate 7 (8%), ferritin 8 (9%), copper 4 (4%), magnesium 4 (4%) and plasma selenium 3 (3%). Zinc deficiency was predictive of a shorter time to subsequent relapse (HR: 6.9; 95%CI [1.9 to 26], p = 0.008); in sub analysis of those with CD this effect was even more profound (p = 0.001). We identified biochemical deficiencies for several micronutrients among adults with IBD clinically in remission. We have also highlighted a significant association between zinc deficiency and time to subsequent disease relapse in patients with CD which needs further investigation.
Sections du résumé
BACKGROUND AND AIMS
ESPEN guidelines advocate patients with inflammatory bowel disease (IBD) have their micronutrient levels checked regularly. This study described the micronutrient status of patients with quiescent IBD and explores whether biochemical micronutrient deficiencies related to time to subsequent disease relapse.
METHODS
Sixteen micronutrients were measured prospectively in blood of patients with IBD in clinical remission [Harvey Bradshaw Index (HBI) ≤4 in Crohn's disease (CD) and a partial Mayo score <2 in ulcerative colitis (UC)]. Patients were followed prospectively using the electronic patient records. The ability of micronutrient status to predict time to relapse was tested with survival analysis and Cox regression.
RESULTS
Ninety-three patients were enrolled; Fifty (54%) were also in biochemical remission defined as a normal faecal calprotectin (<250 μg/g), C-reactive protein (<10 mg/L) and serum albumin (>35 g/L). Deficiencies in vitamin D were identified in 27 (29%), zinc in 15 (16%), vitamin B6 in 13 (14%), vitamin C in 12 (13%) and vitamin B12 in 10 (11%). Fewer participants had low serum folate 7 (8%), ferritin 8 (9%), copper 4 (4%), magnesium 4 (4%) and plasma selenium 3 (3%). Zinc deficiency was predictive of a shorter time to subsequent relapse (HR: 6.9; 95%CI [1.9 to 26], p = 0.008); in sub analysis of those with CD this effect was even more profound (p = 0.001).
CONCLUSION
We identified biochemical deficiencies for several micronutrients among adults with IBD clinically in remission. We have also highlighted a significant association between zinc deficiency and time to subsequent disease relapse in patients with CD which needs further investigation.
Identifiants
pubmed: 32517876
pii: S0261-5614(20)30226-0
doi: 10.1016/j.clnu.2020.05.010
pii:
doi:
Substances chimiques
Leukocyte L1 Antigen Complex
0
Micronutrients
0
Serum Albumin
0
C-Reactive Protein
9007-41-4
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
327-331Informations de copyright
Copyright © 2020 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.
Déclaration de conflit d'intérêts
Conflict of interest KG received research grants and speakers’ fees from Nestle Health Science and Nutricia-Danone outside of this work; The rest of the authors have no conflicts of interest to declare.