patients with inflammatory bowel disease:Mechanisms and possible clinical impact  

作　　者：Trond Espen Detlie Jonas Christoffer Lindstrøm Marte Eide Jahnsen Elisabeth Finnes Heinz Zoller Bjørn Moum Jørgen Jahnsen 

机构地区：[1]Department of Gastroenterology,Akershus University Hospital,Lørenskog 1478,Norway [2]Institute of Clinical Medicine,University of Oslo,Oslo 0316,Norway [3]Health Services Research Unit,Akershus University Hospital,Lørenskog 1478,Norway [4]Division of Medicine,Department of Gastroenterology,Oslo University Hospital Ullevål,Oslo 0424,Norway [5]Department of Medicine II,Gastroenterology and Hepatology,Medical University of Innsbruck,Innsbruck A-6020,Austria

出　　处：《World Journal of Gastroenterology》2021年第17期2039-2053,共15页世界胃肠病学杂志（英文版）

摘　　要：BACKGROUND High-dose intravenous iron is an effective treatment option for iron deficiency(ID)or ID anaemia(IDA)in inflammatory bowel disease(IBD).However,treatment with ferric carboxymaltose(FCM)has been associated with the development of hypophosphatemia.AIM To investigate mechanisms behind the development of hypophosphatemia after intravenous iron treatment,and disclose symptoms and clinical manifestations related to hypophosphatemia short-term.METHODS A prospective observational study of adult IBD patients with ID or IDA was conducted between February 1,2017 and July 1,2018 at two separate university hospitals in the southeast region of Norway.Patients received one dose of 1000 mg of either FCM or ferric derisomaltose(FDI)and were followed for an observation period of at least 7 wk.Blood and urine samples were collected for relevant analyses at baseline,week 2 and at week 6.Clinical symptoms were assessed at the same timepoints using a respiratory function test,a visual analogue scale,and a health-related quality of life questionnaire.RESULTS A total of 106 patients was available for analysis in this study.The FCM treatment group consisted of 52 patients and hypophosphatemia was present in 72.5%of the patients at week 2,and in 21.6%at week 6.In comparison,the FDI treatment group consisted of 54 patients and 11.3%of the patients had hypophosphatemia at week 2,and 3.7%at week 6.The difference in incidence was highly significant at both week 2 and 6(P<0.001 and P<0.013,respectively).We observed a significantly higher mean concentration of intact fibroblast growth factor 23(P<0.001),a significant rise in mean urine fractional excretion of phosphate(P=0.004),a significant decrease of 1,25-dihydroxyvitamin D(P<0.001)and of ionised calcium levels(P<0.012)in the FCM-treated patients compared with patients who received FDI.No clinical symptoms could with certainty be related to hypophosphatemia,since neither the respiratory function test,SF-36(36-item short form health survey)or the visual analogue scale scores result

关 键 词：Iron deficiency HYPOPHOSPHATEMIA Inflammatory bowel disease Ferric carboxymaltose Ferric derisomaltose 

分 类 号：R574[医药卫生—消化系统]