Dig Dis Sci. 2022 Apr 6. doi: 10.1007/s10620-022-07474-z. Online ahead of print.

Laurent Peyrin-Biroulet ^1 2 3, Guillaume Bouguen ⁴, David Laharie ⁵, Gauthier Pellet ⁵, Guillaume Savoye ⁶, Cyrielle Gilletta ⁷, Christophe Michiels ⁸, Anthony Buisson ⁹, Mathurin Fumery ¹⁰, Jean-Noël Trochu ¹¹, Patrice Cacoub ^12 13 14, CARENFER study group

Collaborators

CARENFER study group: 

Gilles Macaigne, Morgane Amil, Aurélien Amiot, Christophe Locher, Mehdi Kaassis, Stéphane Nahon, Robert Benamouzig, Romain Altwegg, Frederic Heluwaert, Pierre Claude, Pierre Andrau, Pauline Veyrard, Nina Dib, Valérie Andrieu, Gabriel Choukroun, Alain Cohen-Solal, Elisabeth Luporsi, Katell Peoc'h

Author information

¹Department of Gastroenterology, University of Lorraine, CHRU-Nancy, 54000, Nancy, France.

²University of Lorraine, Inserm, NGERE, 54000, Nancy, France.

³Inserm NGERE and Department of Gastroenterology, Nancy University Hospital, University of Lorraine, 1 Allée du Morvan, 54511, Vandoeuvre-lès-Nancy, France.

⁴CIC1414, Institut NUMECAN (Nutrition Metabolism and Cancer), CHU Rennes, Univ Rennes, INSERM, 35000, Rennes, France.

⁵Service d'Hépato-gastroentérologie et Oncologie Digestive, CHU de Bordeaux, Hôpital Haut-Lévêque, 33000, Bordeaux, France.

⁶INSERM UMR1073, Université de Rouen, Hôpital Universitaire de Rouen, Rouen, France.

⁷Department of Pancreatology and Gastroenterology, University Hospital of Toulouse Rangueil, 31059, Toulouse Cedex 9, France.

⁸Service d'Hepato-Gastro-Entérologie, CHU Dijon Bourgogne, Dijon, France.

⁹Service d'Hépato-Gastroentérologie, Université Clermont Auvergne, Inserm, 3iHP, CHU Clermont-Ferrand, Clermont-Ferrand, France.

¹⁰Department of Gastroenterology, University Hospital of Amiens, and Peritox, University of Picardie, Amiens, France.

¹¹CHU de Nantes, Nantes, France.

¹²Department of Internal Medicine and Clinical Immunology, Groupe Hospitalier Pitié-Salpêtrière, AP-HP, 83 Boulevard de l'Hôpital, 75651, Paris, Cedex 13, France. patrice.cacoub@aphp.fr.

¹³Immunology-Immunopathology- Immunotherapy (I3), Sorbonne Universités, UPMC Univ Paris 06, INSERM, UMR S 959, Paris, France. patrice.cacoub@aphp.fr.

¹⁴Biotherapy (CIC-BTi) and Inflammation-Immunopathology-Biotherapy Department (DHU i2B), Hôpital Pitié-Salpêtrière, AP-HP, Paris, France. patrice.cacoub@aphp.fr.

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.