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P705 Incidence and risk factors of micronutrient deficiency in the patients with inflammatory bowel disease in Korea: folate, vitamin B12, 25-OH-vitamin D, ferritin

Y. E. Park*1, S. J. Park2, Y. Park2, J. H. Cheon2, T. I. Kim2, W. H. Kim2

1Haeundae Paik Hospital, Division of Gastroenterology, Department of Internal Medicine, Busan, South Korea, 2Yonsei University College of Medicine, Seoul, Korea, Division of Gastroenterology, Department of Internal Medicine, Seoul, South Korea

Background

Inflammatory bowel disease (IBD) patients are vulnerable to micronutrient deficiencies due to diarrhoea-related gastrointestinal loss and lack of dietary intake from anorexia related to disease activity. According to the European Society for Clinical Nutrition and Metabolism (ESPEN) guideline, patients with IBD should be regularly checked for micronutrient deficiencies and certain defects should be adequately corrected. However, there is still limited number of studies on the incidence and risk factors of micronutrient deficiency.

Methods

We retrospectively analysed 105 IBD patients who underwent micronutrient examination including folate, vitamin B12, 25-OH-vitamin D, ferritin from March 2016 to March 2017. In addition, all of these patients had follow-up blood tests 6 months later at single tertiary university hospital.

Results

In the deficiency group, 76 (72.4%) patients had a deficiency in one of the four micronutrients (folate, vitamin B12, 25-OH-vitamin D, and ferritin), and 29 (27.6%) were in the non-deficient group. Deficiency group showed significantly higher rate of young age (mean ± standard deviation [SD], 38.7 ± 14.5 vs. 54.4 ± 15.0; p < 0.001), incidence of deficiency in Crohn’s disease (CD) (CD, ulcerative colitis [UC], and intestinal Behcet’s disease [BD]; 78.9% vs. 14.5% vs. 6.6%; p < 0.001), use of azathioprine (35.5% vs. 10.3%; p = 0.011) and anti TNF agents (50.0% vs. 20.7%; p = 0.006) compared with non-deficient group. On the multi-variate analysis, CD (Hazard ratio [HR], 3.600; 95% confidence interval [CI], 1.057–12.253; p = 0.040) and intestinal BD (HR, 15.469; 95% CI, 1.081–221.359; p = 0.044) were determined to be significant independent factors for micro-nutrient deficiency compared with UC.

Conclusion

In conclusion, the incidence of micro-nutrient deficiency is high (72.4%), and CD and intestinal BD were associated with higher risk of deficiency than UC. Therefore, in IBD patients, especially the patients with CD and intestinal BD, need more attention in micro-nutrition.