P124 Iron deficiency in the absence of anemia affects the perception of health-related quality of life in IBD patients in remission
C. Herrera*, V. Robles, E. Navarro, N. Borruel, F. Casellas
Unitat Atenció Crohn-Colitis. Hospital Universitari Vall d'Hebron, Digestive System Research Unit, Barcelona, Spain
Anemia is a common complication of inflammatory bowel disease (IBD) and contributes to the deterioration of health-related quality of life (HRQOL). The IBDQ-36 is a questionnaire that assesses quality of life (QOL) in patients with IBD. It has the advantage of a validated normality cutoff value, which corresponds to a normal perception of QOL, equivalent to that of the general population of reference. Although anemia is multifactorial in IBD, iron deficiency is one of the most prevalent underlying factors and it is present in up to 90% of patients. However, in the absence of anemia, it is unclear to what extent iron deficiency can affect the restoration of the quality of life in patients with IBD. Our aim was to determine whether iron deficiency without anemia negatively affects the restoration of HRQOL in IBD patients in remission.
We carried an observational, prospective, cross-sectional study in IBD patients in clinical remission without anemia according to WHO criteria. All patients signed the informed consent and then completed the IBDQ-36. Blood samples were obtained to determine iron status. Iron deficiency was defined based on serum ferritin <30ng/mL and/or transferrin saturation index < 16%. Restoration of HRQOL score was defined as >209 points on the global IBDQ-36 score. Results were expressed as medians, percentages and percentiles. Fisher's exact test was performed for categorical variables, and for quantitative Mann-Whitney U test. A two-tailed p value <0.05 was considered statistical significant.
One hundred-three patients with IBD in remission were included, 61 with Crohn's disease and 42 with ulcerative colitis. Patients were stratified into two groups: 61 with iron deficiency without anemia and 41 with normal iron status. The median age was 37 years [31-47], and 55% were women. Median hemoglobin was 12.9g/dL in the iron deficient group and 14 in the normal iron group (p=0.02). There were no differences in age, type of IBD, treatment or illness behavior between groups. The prevalence of female patients was higher in the group with iron deficiency (RR: 1.87 95% CI 1.33-2.62, p<0.01). The median global value of the IBDQ-36 was 227 in the iron deficient group and 231 in the normal iron status group (p=ns), but restoration of health was significantly less frequent in iron deficient patients than in patients with normal iron status (RR: 2.5 IC 95% 1.15-5.51, p=0.018).
Iron deficiency in absence of anemia negatively impacts the normal perception of health-related quality of life in IBD patients in remission.
Correction of iron deficiency may be a new target in the treatment of these patients.