Copyright
©The Author(s) 2018.
World J Gastroenterol. Sep 28, 2018; 24(36): 4186-4196
Published online Sep 28, 2018. doi: 10.3748/wjg.v24.i36.4186
Published online Sep 28, 2018. doi: 10.3748/wjg.v24.i36.4186
Table 1 Types of anemia according to iron parameters
Ferritin (ng/mL) | Transferrin saturation (%) | CRP (5 mg/L) | |
IDA | < 30 | < 20 | - |
CDA | > 100 | < 20 | > 5 |
Mixed anemia (IDA + CDA) | > 30 and < 100 | < 20 |
Table 2 Demographic data of inflammatory bowel disease patients n (%)
IBD overall | Crohn’s disease | Ulcerative colitis | P value | |
n | 465 | 257 (55.3) | 208 (44.7) | |
Age (yr) mean (SD; range) | 47.1 (14.3; 18-83) | 46.2 (13.4; 17-78) | 48 (15.3; 12-83) | 0.183 |
Sex (male/female) | 254 (54.6)/211 (45.4) | 153 (59.5)/104 (40.5) | 101 (48.6)/107 (51.4) | 0.019 |
Disease characteristics | ||||
Age at diagnosis (yr) | 40.2 | 39.7 | 40.7 | 0.46 |
Location of the disease | ||||
L1 | 122 (48.2) | |||
L2 | 48 (19) | |||
L3 | 83 (32.8) | |||
L4 | - | |||
Disease behavior | ||||
B1 | 148 (60.9) | |||
B2 | 40 (16.5) | |||
B3 | 55 (22.6) | |||
Disease extension | ||||
E1 | 49 (27.5) | |||
E2 | 73 (41) | |||
E3 | 56 (31.5) | |||
Drugs | ||||
SZP/5-ASA | 360 (77.4) | 171 (66.5) | 189 (90.6) | < 0.001 |
Corticosteroids | 55 (11.8) | 30 (11.7) | 25 (12) | 0.90 |
Budenoside | 17 (3.7) | 15 (5.8) | 2 (1) | 0.005 |
AZA / MTX | 200 (43) | 155 (60.3) | 45 (21.6) | < 0.001 |
IFX/ADA | 81 (17.4) | 72 (28) | 9 (4.3) | < 0.001 |
Antibiotic | 92 (19.8) | 68 (26.5) | 24 (11.5) | < 0.001 |
Surgery | 70 (15.1) | 60 (23.3) | 10 (4.8) | < 0.001 |
Table 3 Prevalence of anemia and hematological profile at the time of diagnosis in patients with inflammatory bowel disease n (%)
IBD overall | Crohn’s disease | Ulcerative colitis | P value | |
Anemia | 240 (51.6) | 148 (57.6) | 92 (44.2) | 0.005 |
Severe anemia | 64 (16.4) | 47 (21.6) | 17 (9.8) | 0.002 |
Hemoglobin (g/dL) mean (SD; range) | 12.3 (2.1; 5.3-17.9) | 12.1 (2.2; 5.3-16.8) | 12.5 (1.9; 7.1-17.9) | 0.03 |
Hematocrit (%) mean (SD; range) | 37.41 (6.1; 10-53) | 36.8 (6.6; 10-52) | 38.16 (5.3; 22-53) | 0.02 |
MCV (fL) mean (SD; range) | 84.54 (7.7; 57-112) | 84.75 (8.3; 58-112) | 84.28 (7; 57-100) | 0.46 |
Iron (μg/dL) mean (SD; range) | 43.76 (30.3; 4-160) | 43.26 (30.4; 4-126) | 44.5 (30; 4-160) | 0.73 |
Ferritin (μg/dL) mean (SD; range) | 40.3 (74; 2-754) | 48.96 (91; 2-754) | 27.26 (37; 2-167) | 0.01 |
TS (%) mean (SD; range) | 15.35 (13; 2-100) | 15.14 (12.7; 2-100) | 15.67 (12; 2-92) | 0.9 |
CRP (mg/L) mean (SD; range) | 13 (29; 1-289) | 17.1 (32.8; 0-289) | 7.9 (7.93; 1-242) | 0.001 |
Albumin mean (SD; range) | 4.2 (0.4; 1.9-5.0) | 4.1 (0.4; 1.9-4.9) | 4.1 (0.4; 2.0-5.0) | 0.17 |
Table 4 Evaluation of disease characteristics according to types of anemia in inflammatory bowel disease n (%)
Anemia | IDA | CDA | Mixed anemia | B12/Folic acid anemia | Other anemia | |
Sex | ||||||
M | 105 (41.3) | 48 (18.9) | 18 (7.1) | 8 (3.8) | 34 (13.4) | 35 (13.8) |
F | 135 (64) | 91 (43.1) | 19 (9) | 8 (3.1) | 31 (14.6) | 36 (17.1) |
P value | < 0.001 | < 0.001 | 0.44 | 0.7 | 0.6 | 0.32 |
Disease duration (yr) | ||||||
A+ | 6.6 | 6.7 | 6.1 | 5.9 | 5.9 | 6.8 |
A - | 7.1 | 6.9 | 6.9 | 6.9 | 7 | 6.9 |
P value | 0.55 | 0.45 | 0.31 | 0.14 | 0.36 | |
Disease type | ||||||
CD | 148 (57.6) | 84 (32.7) | 31 (12.1) | 13 (5.1) | 50 (19.4) | 39 (15.2) |
UC | 92 (44.2) | 55 (26.4) | 6 (2.9) | 3 (1.4) | 15 (7.2) | 32 (15.4) |
P value | 0.004 | 0.14 | < 0.001 | 0.03 | 0.001 | 0.95 |
Disease localization | ||||||
L1 | 66 (54.1) | 34 (27.9) | 13 (10.7) | 5 (4.1) | 25 (20.5) | 19 (15.6) |
L2 | 29 (60.4) | 17 (35.4) | 8 (16.7) | 1 (2.1) | 3 (6.3) | 9 (18.8) |
L3 | 50 (60.2) | 31 (37.3) | 9 (13.8) | 6 (7.2) | 22 (26.5) | 10 (12) |
P value | 0.6 | 0.32 | 0.51 | 0.02 | 0.56 | |
Disease behavior | ||||||
B1 | 90 (60.8) | 53 (35.8) | 18 (12.2) | 8 (5.4) | 23 (15.6) | 25 (16.9) |
B2 | 27 (67.5) | 12 (30) | 5 (12.5) | 1 (2.5) | 14 (35) | 6 (15) |
B3 | 26 (47.3) | 16 (29.1) | 8 (14.5) | 4 (7.3) | 12 (21.8) | 6 (10.9) |
P value | 0.1 | 0.59 | 0.9 | 0.02 | 0.57 | |
Disease extension | ||||||
E1 | 16 (32.7) | 6 (12.2) | 1 (2) | 0 | 2 (4.1) | 9 (18.4) |
E2 | 32 (48.8) | 19 (26) | 2 (2.7) | 2 (2.7) | 6 (8.2) | 12 (16.4) |
E3 | 35 (62.5) | 26 (46.4) | 3 (5.4) | 1 (1.8) | 6 (10.7) | 6 (10.7) |
P value | 0.008 | < 0.001 | 0.51 | |||
Corticosteroid use | ||||||
+ | 44 (80) | 28 (50.9) | 10 (18.2) | 4 (7.3) | 15 (27.3) | 10 (18.2) |
None | 196 (47.8) | 111 (27.1) | 27 (6.6) | 12 (2.9) | 50 (12.2) | 61 (14.9) |
P value | < 0.001 | < 0.001 | 0.003 | 0.097 | 0.003 | 0.52 |
AZA/MTX use | ||||||
+ | 129 (64.5) | 73 (36.5) | 25 (12.5) | 11 (5.5) | 45 (22.5) | 36 (18) |
None | 111 (41.9) | 66 (24.5) | 12 (4.5) | 5 (1.9) | 20 (7.5) | 35 (13.2) |
P value | < 0.001 | 0.007 | 0.002 | 0.03 | < 0.001 | 0.15 |
Anti-TNF use | ||||||
+ | 56 (69.1) | 38 (46.9) | 13 (16) | 7 (8.6) | 21 (26) | 11 (13.6) |
None | 184 (47.9) | 101 (26.3) | 24 (6.3) | 9 (2.3) | 44 (11.5) | 60 (15.6) |
P value | 0.001 | < 0.001 | 0.003 | 0.01 | 0.002 | 0.64 |
Surgery | ||||||
+ | 44 (62.9) | 23 (32.9) | 11 (15.7) | 5 (7.19) | 15 (21.4) | 14 (20) |
None | 196 (49.6) | 116 (29.4) | 26 (6.6) | 11 (2.8) | 50 (12.6) | 57 (14.4) |
P value | 0.041 | 0.55 | 0.009 | 0.07 | 0.55 | 0.23 |
CRP (mg/L) | ||||||
< 5 | 109 (41.3) | 70 (26.5) | 7 (2.7) | 3 (1.1) | 31 (11.8) | 29 (11) |
> 5 | 120 (65.6) | 63 (34.4) | 29 (15.8) | 12 (6.6) | 30 (16.4) | 39 (21.3) |
P value | 0.001 | 0.07 | 0.001 | 0.002 | 0.37 | 0.003 |
Table 5 Factors associated with anemia by logistic regression in patients with Crohn’s disease and ulcerative colitis at the diagnosis
Odds ratio | 95%CI | P value | |
All IBD patients | |||
Sex (female) | 3.19 | 2.07-4.91 | < 0.001 |
Corticosteroids | 3.21 | 1.52-6.80 | 0.002 |
AZA/MTX | 2.28 | 1.48-3.49 | < 0.001 |
Anti-TNF (INF/ADA) | 2.32 | 1.30-4.11 | 0.004 |
Elevated CRP | 2.75 | 1.78-4.24 | < 0.001 |
Crohn’s disease | |||
Sex (female) | 4.10 | 2.19-7.68 | < 0.001 |
Corticosteroids | 4.06 | 1.27-12.96 | 0.018 |
AZA/MTX | 2.30 | 1.26-4.20 | 0.006 |
Anti-TNF (INF/ADA) | 2.34 | 1.20-4.53 | 0.012 |
Elevated CRP | 3.05 | 1.67-5.58 | < 0.001 |
Ulcerative colitis | |||
Sex (female) | 3.12 | 1.58-6.18 | 0.001 |
Corticosteroids | 3.62 | 1.22-10.67 | 0.02 |
Elevated CRP | 2.03 | 0.96-4.26 | 0.062 |
Disease extension | 3.79 | 1.51-9.55 | 0.005 |
- Citation: Bengi G, Keyvan H, Durmaz SB, Akpınar H. Frequency, types, and treatment of anemia in Turkish patients with inflammatory bowel disease. World J Gastroenterol 2018; 24(36): 4186-4196
- URL: https://www.wjgnet.com/1007-9327/full/v24/i36/4186.htm
- DOI: https://dx.doi.org/10.3748/wjg.v24.i36.4186