Abstract

Background and Aims

Anaemia is common in patients with inflammatory bowel disease [IBD], its two main aetiologies being iron deficiency anaemia [IDA] and anaemia of chronic inflammation [ACI]. Impaired intestinal iron absorption due to inflammatory cytokines is thought to play a role in ACI. We undertook for the first time a controlled prospective study investigating effects of differing underlying diseases, disease locations, and types of iron deficiency or anaemia on oral iron absorption in adult IBD patients with and without inflammation.

Methods

This study was a comparative, single-centred open clinical trial in adults with IBD [n = 73] and healthy controls [n = 22]. Baseline parameters included blood count, iron status [ferritin, transferrin, transferrin saturation, soluble transferrin receptor, hepcidin, serum iron], high-sensitivity C-reactive protein [hsCRP] and interleukin-6. Iron absorption was tested using one oral, enteric-coated capsule containing 567.7 mg iron[II]-glycine-sulphate complex. Serum iron was determined 60/90/120/180/240 min after ingestion.

Results

Iron absorption capacity was shown to be influenced by inflammation and anaemia or iron deficiency [ID] type but not by underlying disease type or localisation. The ACI group showed a significantly lower iron absorption capacity than all others. Whereas hsCRP levels [-0.387, p < 0.001], IL-6 [-0.331, p = 0.006], ferritin [-0.531, p < 0.001], and serum hepcidin [-0.353, p = 0.003] correlated negatively with serum iron change at 2 h, transferrin showed a positive correlation at the same time point [0.379, p < 0.001].

Conclusions

Underlying disease type and localisation appear to have little effect on iron absorption capacity, whereas lack of response to oral iron correlates well with serum markers of inflammation. Iron absorption capacity is thus significantly reduced in the presence of inflammation.

中文翻译：

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炎症而不是潜在疾病或其位置预测炎症性肠病患者的口服铁吸收能力。

抽象的

背景和目标

贫血在炎症性肠病[IBD]中很常见，其两个主要病因是缺铁性贫血[IDA]和慢性炎症性贫血[ACI]。炎症细胞因子引起的肠铁吸收受损被认为在ACI中起作用。我们首次进行了一项对照前瞻性研究，调查了不同潜在疾病，疾病部位以及铁缺乏或贫血类型对有或没有炎症的成年IBD患者口服铁吸收的影响。

方法

这项研究是一项针对成人IBD [ n = 73]和健康对照[ n = 22]的比较性，单中心开放性临床试验。基线参数包括血球计数，铁状态（铁蛋白，转铁蛋白，转铁蛋白饱和度，可溶性转铁蛋白受体，铁调素，血清铁），高敏感性C反应蛋白[hsCRP]和白介素6。使用一种含有567.7 mg铁[II]-甘氨酸-硫酸盐复合物的口服肠溶胶囊来测试铁的吸收。摄入后60/90/120/180/240分钟测定血清铁。

结果

已显示出铁吸收能力受炎症和贫血或铁缺乏症[ID]类型的影响，但不受潜在疾病类型或位置的影响。ACI组显示出比其他所有组明显更低的铁吸收能力。hsCRP水平[-0.387，p <0.001]，IL-6 [-0.331，p = 0.006]，铁蛋白[-0.531，p <0.001]和血清铁调素[-0.353，p = 0.003]与血清铁呈负相关在2 h变化时，转铁蛋白在同一时间点呈正相关[0.379，p <0.001]。

结论

潜在的疾病类型和位置似乎对铁的吸收能力几乎没有影响，而对口服铁的缺乏反应与血清炎症标志密切相关。因此，在发炎的情况下铁的吸收能力显着降低。