Five-Year Period Prevalence and Characteristics of Anemia in a Large US Inflammatory Bowel Disease Cohort.
Five-Year Period Prevalence and Characteristics of Anemia in a Large US Inflammatory Bowel Disease Cohort.
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DOI：
10.1097/mcg.0000000000000417
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发表时间：
2016-09
影响因子：
2.9
通讯作者：
Binion DG
中科院分区：
文献类型：
--
作者：
Koutroubakis IE;Ramos-Rivers C;Regueiro M;Koutroumpakis E;Click B;Schwartz M;Swoger J;Baidoo L;Hashash JG;Barrie A;Dunn MA;Binion DG
贫血是炎症性肠病（IBD）的常见表现，但其在美国的患病率尚不明确。本研究的目的是确定在美国转诊中心随访的IBD患者贫血的患病率和特征。分析了2009-2013年期间前瞻性、知情同意纵向IBD登记研究的人口统计学、临床、实验室和治疗数据。采用Harvey-Bradshaw指数（HBI）和溃疡性结肠炎（UC）活动指数（UCAI）以及C-反应蛋白（CRP）和红细胞沉降率（ESR）评估疾病活动性。贫血是根据世界卫生组织的标准定义的。共纳入1821例IBD患者[1077例CD患者，744例UC患者，中位年龄43.8岁，51.9%为女性]。IBD患者5年贫血患病率为50.1%，CD为53.3%，UC为44.7%，P =0.001。在多变量logistic回归分析中，贫血与IBD手术相关[比值比（OR）2.77，95%CI]（2.21-3.48）P<0.0001）]，女性（OR 1.29 95% CI 1.04-1.61 P=0.02），CRP（OR 1.26 95%CI 1.16-1.37 P<0.0001），ESR（OR 1.02 95%CI 1.01-1.03 P=0.0002）和使用生物制剂（OR 2.00 95%CI 1.58-2.52 P=0.0001）或免疫调节剂（OR 1.51 95%CI 1.21-1.87 P=0.0003）。46.8%的贫血患者接受了铁替代治疗。贫血在三级中心随访的IBD患者中具有较高的时期患病率。贫血在CD中比在UC中更常见，与疾病活动性相关，并且在当前实践中治疗不足。
Anemia is a common manifestation of inflammatory bowel disease (IBD) but its prevalence in the U.S. is not well defined. Aim of this study was to determine the prevalence and characteristics of anemia in IBD patients who were followed in a U.S. referral center. Demographic, clinical, laboratory and treatment data from a prospective, consented longitudinal IBD registry between the years 2009-2013 were analyzed. Disease activity was evaluated using Harvey-Bradshaw index (HBI) in Crohn’s disease (CD) and ulcerative colitis (UC) activity index (UCAI) in UC as well as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). Anemia was defined based on the World Health Organization criteria. A total of 1821 IBD patients [1077 with CD, 744 with UC, median age 43.8 years, 51.9% female] were included. The 5-year period prevalence of anemia in IBD patients was 50.1%, (CD: 53.3% vs UC: 44.7%, P =0.001). In multivariate logistic regression analysis anemia was associated with surgery for IBD [odds ratio (OR) 2.77 95% confidence inderval (CI) (2.21-3.48) P<0.0001)], female gender (OR 1.29 95% CI 1.04-1.61 P=0.02), CRP (OR 1.26 95%CI 1.16-1.37 P<0.0001), ESR (OR 1.02 95%CI 1.01-1.03 P=0.0002) and use of biologics (OR 2.00 95%CI 1.58-2.52 P=0.0001) or immunomodulators (OR 1.51 95%CI 1.21-1.87 P=0.0003). Iron replacement therapy was administered to 46.8% of the anemic patients. Anemia has a high period prevalence in IBD patients followed at a tertiary center. Anemia is more common in CD than in UC, is associated with disease activity and in current practice is undertreated.