title: Anemia at the time of diagnosis of inflammatory bowel disease: Prevalence and associated factors in adolescent and adult patients.
abstract: BACKGROUND
  The prevalence, characteristic and determinants of anemia, at the time of inflammatory bowel disease (IBD) diagnosis have yet to be fully elucidated.
  
  
  METHODS
  Retrospective cross-sectional study. Analytical data and disease characteristics obtained upon diagnosis of 1278 IBD patients [Crohn's disease/ulcerative colitis (CD/UC): 718/560] were collected.
  
  
  RESULTS
  Anemia was present in 41.2% of patients at diagnosis (47% and 33.8% of CD and UC patients, respectively; p<0.001), being severe in 5.5%. Iron deficiency anemia represented 69.6% of cases, with no differences between CD and UC. Female sex was the strongest risk factor for anemia in both CD and UC (OR 7.11; 95%CI 4.18-12.10 and 6.55; 95%CI 3.39-12.63, respectively), followed by elevated (≥2mg/dL) C-reactive protein (OR 4.08; 95%CI 2.39-6.97 and 4.58; 95%CI 2.26-9.27, respectively). Current smoking was a risk factor for anemia in CD (OR 2.23; 95%CI 1.24-4.02), but a protective one in UC (OR 0.36; 95%CI 0.14-0.92). A penetrating CD behavior increased the risk of anemia (OR 3.34; 95%CI 1.36-8.21); in UC, anemia increased with disease extension (E2+E3) (OR 1.80; 95%CI 1.13-2.86).
  
  
  CONCLUSIONS
  Female sex and disease activity are major determinants of anemia at IBD diagnosis. Anemia is associated with disease behavior in CD and with disease extension in UC.
authors.affiliation: Department of Gastroenterology, Hospital General de Tomelloso, Tomelloso, Ciudad Real, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Spain. Electronic address: alucendo@vodafone.es.
authors.forename: Alfredo J
authors.initials: AJ
authors.lastname: Lucendo
authors.affiliation: Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Spain; Research Support Unit, Hospital General La Mancha Centro, Alcázar de San Juan, Spain.
authors.forename: Ángel
authors.initials: Á
authors.lastname: Arias
authors.affiliation: Department of Gastroenterology, Hospital General La Mancha Centro, Alcázar de San Juan, Spain.
authors.forename: Óscar
authors.initials: Ó
authors.lastname: Roncero
authors.affiliation: Department of Gastroenterology, Hospital Virgen de Altagracia, Manzanares, Spain.
authors.forename: Daniel
authors.initials: D
authors.lastname: Hervías
authors.affiliation: Department of Gastroenterology/IBD Unit, Hospital General Universitario de Ciudad Real, Spain.
authors.forename: Cristina
authors.initials: C
authors.lastname: Verdejo
authors.affiliation: Department of Gastroenterology, Hospital Gutierrez Ortega, Valdepeñas, Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: Naveas-Polo
authors.affiliation: Department of Gastroenterology, Hospital Santa Bárbara, Puertollano, Spain.
authors.forename: Abdelmouneim
authors.initials: A
authors.lastname: Bouhmidi
authors.affiliation: Department of Gastroenterology/IBD Unit, Hospital General Universitario de Ciudad Real, Spain.
authors.forename: Rufo
authors.initials: R
authors.lastname: Lorente
authors.affiliation: Department of Gastroenterology, Hospital Gutierrez Ortega, Valdepeñas, Spain.
authors.forename: Luis Miguel
authors.initials: LM
authors.lastname: Alcázar
authors.affiliation: Department of Gastroenterology, Hospital Santa Bárbara, Puertollano, Spain.
authors.forename: Irina
authors.initials: I
authors.lastname: Salueña
authors.affiliation: Department of Gastroenterology, Hospital General de Tomelloso, Tomelloso, Ciudad Real, Spain.
authors.forename: Julio A
authors.initials: JA
authors.lastname: García-Quiñones
authors.affiliation: Department of Gastroenterology, Hospital General de Tomelloso, Tomelloso, Ciudad Real, Spain.
authors.forename: María Jesús
authors.initials: MJ
authors.lastname: Carrillo-Ramos
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000453:epidemiology*; D002097:C-Reactive Protein / Q000032:analysis; D003093:Colitis, Ulcerative / Q000150:complications*; D003424:Crohn Disease / Q000150:complications*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D013030:Spain; D055815:Young Adult
chemical_list: D002097:C-Reactive Protein
keywords: Anemia; Crohn’s disease; Inflammatory bowel disease; Ulcerative colitis