P0743 - Micronutrient Deficiencies Are Not Associated With Worsened Rates of Adverse Clinical Outcomes in Older Patients With Inflammatory Bowel Disease

Brendan Andres, MD¹, Garrett Pepich, DO¹, Ali Rasool, MD², Chiu-Hsieh Hsu, PhD³, Sasha Taleban, MD^1
1University of Arizona College of Medicine, Tucson, AZ; ²University of Arizona, Tucson, AZ; ³Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ

Introduction: Micronutrient deficiencies (MND) commonly occur in inflammatory bowel disease (IBD) patients and correspond with poor clinical outcomes. Advanced age is a risk factor for MND. We sought to evaluate MND rates in older and younger adult IBD patients and determine their correlation with adverse clinical outcomes.

Methods: We conducted a retrospective cohort study of a single, tertiary-care institution. IBD patients with >1 year of follow-up were divided into 2 arms: 1) younger adults, age 18-59, and 2) older adults, age ≥ 60 years old. Demographic and disease factors were evaluated. All patients were separated by number of MND(s): 1) < 1 MND and 2) ≥ 1 MND(s). MNDs included iron, vitamin D, zinc, vitamin B12, and folate. Primary outcomes included subsequent need for corticosteroids, combined intestinal complication (intra-abdominal abscess, intestinal stricture, internal fistula, peri-anal disease), IBD-related surgery or hospitalization, and a composite clinical outcome of any single outcome occurrence. Statistical analyses included chi-squared and Fisher’s Exact test.

Results: The study population consisted of 204 adult IBD patients of which 70 were older adults. Rates of current corticosteroid and biologic use were similar in both groups. Mean follow-up duration was 3.1 years. Some MNDs were more common (vitamin D 66.8%, iron 48.2%, zinc 37.4%), though all MND rates were similar between the two groups. Compared to younger adults with a MND, older adults with a MND had less corticosteroid use (36.6% vs 18.6%, p = 0.01) and a better composite clinical outcome (48.5% vs 25.7%, p < 0.01) (Table 1). Similarly, adverse clinical outcomes were not associated with specific MNDs in the older adult cohort. In all patients, having multiple MNDs corresponded with combined intestinal complication (27.3% vs 7.1%, p < 0.01), IBD-related surgery (15.6% vs 2.4%, p < 0.01), and IBD-related hospitalization (26.0% vs 11.0%, p < 0.01). However, older adults with multiple MNDs had a better composite outcome than younger adults with multiple MNDs (57.4% vs 26.1%, p < 0.01).

Discussion: MNDs were present in a majority of IBD patients regardless of age. Deficiencies in vitamin D and iron and having multiple MNDs corresponded to worse outcomes. However, compared to younger adults, older adults with MND(s) were less likely to have increased rates of adverse clinical outcomes. This may suggest that compared to younger adults, in older IBD patients, MND(s) may not be as effective a marker for disease severity.



Disclosures:


Brendan Andres, MD¹, Garrett Pepich, DO¹, Ali Rasool, MD², Chiu-Hsieh Hsu, PhD³, Sasha Taleban, MD¹. P0743 - Micronutrient Deficiencies Are Not Associated With Worsened Rates of Adverse Clinical Outcomes in Older Patients With Inflammatory Bowel Disease, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.