Calcium deficiency is associated with malnutrition risk in patients with inflammatory bowel disease

ABSTRACT

Background and Aim

Patients with inflammatory bowel disease (IBD) often have the condition of malnutrition, which can be presented as sarcopenia, micronutrient deficiencies, etc. Trace elements (magnesium, calcium, iron, copper, zinc, plumbum and manganese) belonging to micronutrients, are greatly vital for the assessment of nutritional status in humans. Trace element deficiencies are also the main manifestation of malnutrition. Calcium (Ca) has been proved to play an important part in maintaining body homeostasis and regulating cellular function. However, there are still a lack of studies on the association between malnutrition and Ca deficiency in IBD. This research aimed to investigate the role of Ca for malnutrition in IBD patients.

Methods

We prospectively collected blood samples from 149 patients and utilized inductively coupled plasma mass spectrometry to examine their venous serum trace element concentrations. Logistic regression analyses were used to investigate the association between Ca and malnutrition. Receiver operating characteristic (ROC) curves were generated to calculate the cutoffs for determination of Ca deficiency.

Results

Except Ca, the concentrations of the other six trace elements presented no statistical significance between non-malnutrition and malnutrition group. In comparison with the non-malnutrition group, the serum concentration of Ca decreased in the malnutrition group (89.36 vs 87.03 mg/L, p = 0.023). With regard to ROC curve, Ca < 87.21 mg/L showed the best discriminative capability with an area of 0.624 (95% CI: 0.520, 0.727, p = 0.023). Multivariate analyses demonstrated that Ca < 87.21 mg/L (OR = 3.393, 95% CI: 1.524, 7.554, p = 0.003) and age (OR = 0.958, 95% CI: 0.926, 0.990, p = 0.011) were associated with malnutrition risk. Serum Ca levels were significantly lower in the malnutrition group than those in the non-malnutrition group among UC patients, those with severe disease state or the female group.

Conclusions

In patients with IBD, Ca deficiency is an independent factor for high malnutrition risk.

KEYWORDS:

• Calcium deficiency
• trace elements
• malnutrition
• IBD
• GLIM

Declaration of financial/other relationships

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

Zihan Yu: designed the study and wrote the original manuscript. Wenxuan Song: wrote the original manuscript and analyzed the data. Xiangfeng Ren: wrote the original manuscript and analyzed the data. Jihua Chen: edited the manuscript and collected the data. Qinyan Yao: edited the manuscript and collected the data. Hang Liu: edited the manuscript and collected the data. Xiaoxuan Wang: conducted the laboratory study. Jinjie Zhou: conducted the laboratory study. Bangmao Wang: designed the study and made critical revisions to the manuscript. Xin Chen: designed the study, polished the manuscript and made critical revisions to the manuscript.

Ethics statement

The studies involving human participants were reviewed and approved by Ethics Committee of the hospital. The patients provided their written informed consent to participate in this study.

Data availability statement

The raw data supporting the conclusions of this article will be made available by the corresponding authors.

Additional information

Funding

This work was supported by the Natural Science Foundation of Tianjin [21JCQNJC01130] and National Natural Science Funds of Young Scholar [No.82100565].