Patients hospitalized with inflammatory bowel disease (IBD) have a risk for various micronutrient deficiencies, including 25(OH)D and folate, according to study results published in Nutrition.

The retrospective, observational study assessed the prevalence, correlations, and relevant factors of micronutrient deficiencies in 52 patients with IBD (34 with Crohn disease [CD], 18 with ulcerative colitis [UC]). Study participants were aged 16 to 75 years and received hospitalized treatment at a tertiary care center from August 2019 to February 2021.

Clinical data were obtained from patients’ medical records. Disease activity for CD was assessed with use of the Crohn’s Disease Activity Index, and UC disease activity was assessed with the Partial Mayo Score. Linear or logistic regression analyses were used to analyze relevant factors of micronutrient deficiencies.

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The participants had a mean age of 46.19±16.41 years, 33 were men, and their average body mass index (BMI) was 20.72±3.19 kg/m2.

The incidence rates of micronutrient deficiencies in all participants were 76.9% (95% CI, 65.1%-88.8%) for 25(OH)D, 23.1% (95% CI, 11.2%-34.9%) for folate, 11.5% (95% CI, 2.6%-20.5%) for vitamin B12, 44.2% (95% CI, 30.3%-58.2%) for ferritin, 25.0% (95% CI, 12.8%-37.2%) for calcium, and 5.8% (95% CI, 0.8%-12.3%) for magnesium.

Patients who were recently diagnosed with IBD vs patients with a previous diagnosis had a higher incidence of folate deficiency (37.0% vs 8.0%, P =.013) and a lower incidence of iron deficiency (29.6% vs 60.0%, P =.028).

Correlation analysis showed positive interactions between 25(OH)D and multiple micronutrients, including folate (rs=0.292, P =.036), vitamin B12 (rs=0.292, P =.035), and calcium (rs=0.415, P =.002). Calcium was positively correlated with albumin (rs=0.810, P <.001).

Patients with lower calcium levels had a greater number of hospital days compared with those who had normal calcium levels (16.92±9.48 days vs 12.18±11.03 days, P =.016). A significantly negative correlation was found between calcium levels and hospital days (rs=-0.442, P =.001).

25(OH)D was an independent factor for malnutrition (odds ratio [OR], 0.866; 95% CI, 0.744-0.982, P =.025), which suggests that low 25(OH)D increased the risk for overall malnutrition.

In multivariate logistic regression analysis, for each 1-g/L increase in hemoglobin or each 1-ng/mL increase in folate, a 7% (OR, 0.930; 95% CI, 0.870-0.993; P =.034) or 29.2% (OR, 0.708; 95% CI, 0.545-0.922; P =.037) relative reduction was observed in the risk for 25(OH)D deficiency, respectively.

The researchers noted that they did not analyze seasonal vitamin D levels and dietary habits in the participants.

“The results suggest that micronutrient levels should be monitored and supplemented early in the diagnosis of IBD patients,” the study authors noted. “Patients with IBD should be screened annually for micronutrient deficiencies and corrected as appropriate, as recommended by the European Society for Clinical Nutrition and Metabolism (2020) guidelines.”


Li X, Hu Y, Shi X, Zhu X, Liu F. Prevalence and relevant factors of micronutrient deficiencies in hospitalized patients with inflammatory bowel disease. Nutrition. Published online March 31, 2022. doi:10.1016/j.nut.2022.111671