Should we monitor vitamin B12 and folate levels in Crohn's disease patients?
SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY(2013)
摘要
Objective. Crohn's disease commonly involves the small intestine, which is the site of vitamin B-12 and folate absorption. Our aim was to define the prevalence of vitamin B-12 and folate deficiency in patients with Crohn's disease and to identify predictive factors associated with such abnormalities. Methods. Two years prospective study of 180 consecutive Crohn's disease patients. Vitamin B-12 and folate deficiency was defined as serum levels below 200 pg/ml and 3 ng/ml, respectively. We analysed prevalence of these deficiencies and possible predictive factors including small intestine resection, disease location, activity and duration of disease. Controls were ulcerative colitis patients (n = 70). Results. The prevalence of B-12 deficiency in Crohn's disease was 15.6% (95% CI 9.7-20%) compared with 2.8% (95% CI 0.8-9.8%) in ulcerative colitis (p = 0.007). With regard to folate deficiency, the prevalence in patients with Crohn's disease was 22.2% (95% CI 16-28%) compared with 4.3% (95% CI 1.4-12%) in ulcerative colitis (p = 0.001); 7.8% of Crohn's disease patients had macrocytic anemia. Ileal resection was found to be a risk factor for B-12 deficiency (OR 2.7; 1.2-6.7; p = 0.02), and disease activity a risk factor for folate deficiency (OR 2.4; 1.2-5.1; p = 0.01). Conclusion. A significant proportion of patients with Crohn's disease suffer from vitamin B-12 and/or folate deficiency, suggesting that regular screening should be performed, with closer monitoring in patients with ileal resection or active disease.
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关键词
anemia,Crohn's disease,folate,ileal resection,vitamin B-12
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