Iron Deficiency in the Absence of Anemia Impairs the Perception of Health-Related Quality of Life of Patients with Inflammatory Bowel Disease

Background:Anemia is a common complication of inflammatory bowel disease (IBD) and contributes to the deterioration of health-related quality of life (HRQOL). Iron deficiency (ID) is a prevalent underlying factor, present in up to 90% of patients. In the absence of anemia, it is unclear as to what extent ID can affect HRQOL in patients with IBD. Our aim was to determine whether ID without anemia negatively affects normal perception of HRQOL in patients with IBD in remission.Methods:We conducted a prospective, cross-sectional study in patients with IBD in remission without anemia. Blood samples were obtained to determine iron status, and patients completed the Inflammatory Bowel Disease Questionnaire-36. ID was defined on serum ferritin <30 ng/mL and transferrin saturation <16%. Restoration of HRQOL was defined as 209 on the Inflammatory Bowel Disease Questionnaire-36.Results:One hundred-four patients with IBD in clinical remission were included; 45 patients were iron deficient and 59 had normal iron status. All patients were in clinical remission, with a median Harvey-Bradshaw Index 0 and Simple Clinical Colitis Activity Index 0. Median hemoglobin was 12.8 g/dL in the ID group and 13.9 g/dL in the normal iron status group (P < 0.05). Prevalence of female patients was higher in the ID group (odds ratio, 4.45; 95% CI, 1.7-11.7; P < 0.01). The median global value of Inflammatory Bowel Disease Questionnaire-36 was not different between the groups (219 in the ID group versus 230 in the normal iron status group, P = not significant), but restoration of health was significantly less frequent in patients with ID (odds ratio, 2.83; 95% CI, 1.22-6.6; P < 0.05).Conclusions:ID in absence of anemia negatively impacts normal perception of HRQOL in patients with IBD in remission. Correction of ID may be a new target in the treatment of these patients.