Retrospective Study
Copyright ©The Author(s) 2022.
World J Gastroenterol. Sep 7, 2022; 28(33): 4834-4845
Published online Sep 7, 2022. doi: 10.3748/wjg.v28.i33.4834
Table 1 Baseline characteristics
All IBD patients (n = 301)
Female sex190 (63.1%)
Age (yr)47.6 ± 17.4
Ethnicity
Caucasian230 (76.4%)
Hispanic16 (5.3%)
African-American5 (1.7%)
Asian14 (4.7%)
Not specified36 (12.0%)
BMI24.8 ± 5.2
Obesity (BMI ≥ 30)142 (14.4%)
Active smoking6 (2.0%)
CD201 (66.8%)
Disease location
Ileal57 (28.4%)
Colonic34 (16.9%)
Ileocolonic108 (53.7%)
Upper disease10 (5.0%)
Behavior
Non-stricturing, non-penetrating106 (52.7%)
Stricturing74 (36.8%)
Penetrating47 (23.4%)
UC100 (36.8%)
Disease location1
Proctitis14 (14.7%)
Left-sided colitis45 (47.4%)
Pancolitis36 (37.9%)
Disease duration (yr)17.0 ± 13.6
IBD related surgery109 (36.2%)
IBD medications
Current biologic use133 (44.2%)
Past/ever biologic use166 (55.1%)
Clinically active disease1134 (45.9%)
CD96 (49.2%)
UC38 (39.2%)
Endoscopically severe disease120 (17.7%)
CD12 (15.6%)
UC8 (22.2%)
1Ten patients had unknown body mass index. Five ulcerative colitis (UC) patients had unknown disease location. Nine patients did not have disease activity available (6 Crohn’s disease, 3 UC). One hundred thirteen inflammatory bowel disease patients had endoscopies available.
Clinically active disease was defined as Harvey-Bradshaw index > 5 for Crohn’s disease (CD), and stool frequency or rectal bleeding > 1 on modified partial Mayo score for ulcerative colitis (UC). Endoscopically severe disease was defined as simple endoscopic score CD > 15 in CD and endoscopic Mayo score ≥ 2 in UC. IBD: Inflammatory bowel disease; CD: Crohn’s disease; UC: Ulcerative colitis; BMI: Body mass index.
Table 2 Prevalence of vitamin C deficiency in covariate populations
Covariates
Prevalence of vitamin C deficiency in patients with covariate
Prevalence of vitamin C deficiency in patients without covariate
P value
IBD type
CD49/201 (24.4%)-0.1
UC16/100 (16.0%)-0.1
Small bowel disease38/165 (23.0%)11/36 (30.6%)0.3
Penetrating disease17/47 (36.2%)32/154 (20.8%)0.031
IBD related surgery28/109 (25.7%)37/192 (19.3%)0.2
CD25/96 (26.0%)24/105 (22.9%)0.6
UC3/13 (23.1%)13/87 (14.9%)0.4
Obesity (BMI ≥ 30)15/42 (35.7%)49/249 (19.7%)0.021
Active smoking3/6 (50.0%)62/295 (21.0%)0.1
Current biologic use38/133 (28.6%)26/167 (15.6%)0.0061
CRP > 0.9 mg/dL25/64 (39.1%)36/213 (16.9%)< 0.0011
CD21/51 (41.2%)24/134 (17.9%)0.0011
UC4/13 (30.8%)12/79 (15.2%)0.2
Fecal calprotectin > 250 ug/g10/20 (50.0%)12/60 (20.0%)0.0091
CD9/16 (56.3%)10/38 (26.3%)0.041
UC1/4 (25.0%)2/22 (9.1%)0.4
Iron deficiency17/59 (28.8%)39/193 (20.2%)0.2
Vitamin D deficiency/insufficiency11/38 (28.9%)47/221 (21.3%)0.3
Clinically active disease35/134 (26.1%)29/158 (18.4%)0.1
CD29/96 (30.2%)20/99 (20.2%)0.1
UC6/38 (15.8%)9/59 (15.3%)0.9
Endoscopically severe disease7/20 (35.0%)21/93 (22.6%)0.2
CD5/12 (41.7%)18/65 (27.7%)0.3
UC2/8 (25.0%)3/28 (10.7%)0.3
1Patients with penetrating disease, obesity, biologic use, elevated C-reactive protein and elevated fecal calprotectin had increased frequency of vitamin C deficiency.
Clinically active disease was defined as Harvey-Bradshaw index > 5 for Crohn’s disease (CD), and stool frequency or rectal bleeding > 1 on modified partial Mayo score for ulcerative colitis (UC). Endoscopically severe disease was defined as simple endoscopic score CD > 15 in CD and endoscopic Mayo score ≥ 2 in UC. IBD: Inflammatory bowel disease; CD: Crohn’s disease; UC: Ulcerative colitis; BMI: Body mass index; CRP: C-reactive protein.
Table 3 Clinical features of vitamin C deficiency
Vitamin C deficiency (n = 65)
Normal vitamin C level (n = 236)
P value
Presence of ≥ 1 clinical feature(s) of scurvy43 (66.2%)138 (58.5%)0.3
None22 (33.8%)98 (41.5%)-
Fatigue28 (43.1%)65 (27.5%)0.021
Arthritis/arthralgias27 (41.5%)96 (40.7%)0.9
Skin findings (rash, hyperpigmentation)9 (13.8%)29 (12.3%)0.7
Easy bruising6 (9.2%)9 (3.8%)0.1
Gingivitis3 (4.6%)6 (2.5%)0.4
Poor wound healing3 (4.6%)1 (0.4%)0.031
Perifollicular findings (hemorrhage, folliculitis)2 (3.1%)1 (0.4%)0.1
Alopecia1 (1.5%)5 (2.1%)1.0
1Patients with vitamin C deficiency were more likely to report fatigue and poor wound healing.
There was no difference in presence of clinical features of scurvy between patients with vitamin C deficiency and those without.