{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T21:22:55Z","timestamp":1793395375722,"version":"4.5.0"},"reference-count":33,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,1,21]],"date-time":"2021-01-21T00:00:00Z","timestamp":1611187200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,1,21]],"date-time":"2021-01-21T00:00:00Z","timestamp":1611187200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Gastroenterol"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Patients with inflammatory bowel disease (IBD) and intestinal Beh\u00e7et\u2019s disease (BD) are vulnerable to micronutrient deficiencies due to diarrhea-related gastrointestinal loss and poor dietary intake caused by disease-related anorexia. However, few studies have investigated the incidence and risk factors for micronutrient deficiency.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed 205 patients with IBD who underwent micronutrient examination, including folate, vitamin B12, 25-OH-vitamin D, and\/or ferritin level quantification, with follow-up blood tests conducted 6\u00a0months later.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Eighty patients (39.0%), who were deficient in any of the four micronutrients, were classified as the deficiency group, and the remaining 125 (61.0%) were classified as the non-deficient group. Compared to those in the non-deficiency group, patients in the deficiency group were much younger, had more Crohn's disease (CD) patients, more patients with a history of bowel operation, and significantly less 5-amino salicylic acid usage. Multivariate analysis revealed that CD and bowel operation were significant independent factors associated with micronutrient deficiency.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The incidence of micronutrient deficiency was high (39.0%). Factors including CD, bowel operation, and younger ages were found to be associated with higher risks of deficiency. Therefore, patients with IBD, especially young patients with CD who have undergone bowel resection surgery, need more attention paid to micronutrition.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12876-021-01609-8","type":"journal-article","created":{"date-parts":[[2021,1,21]],"date-time":"2021-01-21T07:04:18Z","timestamp":1611212658000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":40,"title":["Incidence and risk factors of micronutrient deficiency in patients with IBD and intestinal Beh\u00e7et\u2019s disease: folate, vitamin B12, 25-OH-vitamin D, and ferritin"],"prefix":"10.1186","volume":"21","author":[{"given":"Yong Eun","family":"Park","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soo Jung","family":"Park","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae Jun","family":"Park","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae Hee","family":"Cheon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"TaeIl","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Won Ho","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,1,21]]},"reference":[{"issue":"1","key":"1609_CR1","first-page":"26","volume":"16","author":"SH Lee","year":"2018","unstructured":"Lee SH, Kwon JE, Cho ML. Immunological pathogenesis of inflammatory bowel disease. Int Res. 2018;16(1):26\u201342.","journal-title":"Int Res"},{"issue":"9573","key":"1609_CR2","doi-asserted-by":"publisher","first-page":"1641","DOI":"10.1016\/S0140-6736(07)60751-X","volume":"369","author":"DC Baumgart","year":"2007","unstructured":"Baumgart DC, Sandborn WJ. Inflammatory bowel disease: clinical aspects and established and evolving therapies. Lancet (London). 2007;369(9573):1641\u201357.","journal-title":"Lancet (London)"},{"issue":"17","key":"1609_CR3","doi-asserted-by":"publisher","first-page":"1284","DOI":"10.1056\/NEJM199910213411707","volume":"341","author":"T Sakane","year":"1999","unstructured":"Sakane T, Takeno M, Suzuki N, Inaba G. Beh\u00e7et\u2019s disease. N Engl J Med. 1999;341(17):1284\u201391.","journal-title":"N Engl J Med"},{"issue":"3","key":"1609_CR4","doi-asserted-by":"publisher","first-page":"307","DOI":"10.1046\/j.1365-2036.2003.01482.x","volume":"17","author":"J Goh","year":"2003","unstructured":"Goh J, O\u2019Morain CA. Review article: nutrition and adult inflammatory bowel disease. Aliment Pharmacol Ther. 2003;17(3):307\u201320.","journal-title":"Aliment Pharmacol Ther"},{"issue":"697","key":"1609_CR5","doi-asserted-by":"publisher","first-page":"690","DOI":"10.1136\/pgmj.59.697.690","volume":"59","author":"AD Harries","year":"1983","unstructured":"Harries AD, Heatley RV. Nutritional disturbances in Crohn\u2019s disease. Postgrad Med J. 1983;59(697):690\u20137.","journal-title":"Postgrad Med J"},{"issue":"17","key":"1609_CR6","doi-asserted-by":"publisher","first-page":"2081","DOI":"10.3748\/wjg.15.2081","volume":"15","author":"AJ Lucendo","year":"2009","unstructured":"Lucendo AJ, De Rezende LC. Importance of nutrition in inflammatory bowel disease. World J Gastroenterol. 2009;15(17):2081\u20138.","journal-title":"World J Gastroenterol"},{"issue":"3","key":"1609_CR7","first-page":"311","volume":"15","author":"HJ Lee","year":"2017","unstructured":"Lee HJ, Cheon JH. Optimal diagnosis and disease activity monitoring of intestinal Beh\u00e7et\u2019s disease. Int Res. 2017;15(3):311\u20137.","journal-title":"Int Res"},{"issue":"1","key":"1609_CR8","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1186\/s12969-017-0162-4","volume":"15","author":"S Valenti","year":"2017","unstructured":"Valenti S, Gallizzi R, De Vivo D, Romano C. Intestinal Beh\u00e7et and Crohn\u2019s disease: two sides of the same coin. Pediatric Rheumatol Online J. 2017;15(1):33.","journal-title":"Pediatric Rheumatol Online J"},{"issue":"10","key":"1609_CR9","doi-asserted-by":"publisher","first-page":"1961","DOI":"10.1002\/ibd.22906","volume":"18","author":"C Hwang","year":"2012","unstructured":"Hwang C, Ross V, Mahadevan U. Micronutrient deficiencies in inflammatory bowel disease: from A to zinc. Inflamm Bowel Dis. 2012;18(10):1961\u201381.","journal-title":"Inflamm Bowel Dis"},{"issue":"6","key":"1609_CR10","doi-asserted-by":"publisher","first-page":"904","DOI":"10.1016\/j.clnu.2013.03.020","volume":"32","author":"S Massironi","year":"2013","unstructured":"Massironi S, Rossi RE, Cavalcoli FA, Della Valle S, Fraquelli M, Conte D. Nutritional deficiencies in inflammatory bowel disease: therapeutic approaches. Clin Nutr (Edinburgh). 2013;32(6):904\u201310.","journal-title":"Clin Nutr (Edinburgh)"},{"issue":"2","key":"1609_CR11","doi-asserted-by":"publisher","first-page":"321","DOI":"10.1016\/j.clnu.2016.12.027","volume":"36","author":"A Forbes","year":"2017","unstructured":"Forbes A, Escher J, Hebuterne X, Klek S, Krznaric Z, Schneider S, Shamir R, Stardelova K, Wierdsma N, Wiskin AE, et al. ESPEN guideline: Clinical nutrition in inflammatory bowel disease. Clin Nutr (Edinburgh). 2017;36(2):321\u201347.","journal-title":"Clin Nutr (Edinburgh)"},{"issue":"7","key":"1609_CR12","first-page":"744","volume":"84","author":"F Fernandez-Banares","year":"1989","unstructured":"Fernandez-Banares F, Abad-Lacruz A, Xiol X, Gine JJ, Dolz C, Cabre E, Esteve M, Gonzalez-Huix F, Gassull MA. Vitamin status in patients with inflammatory bowel disease. Am J Gastroenterol. 1989;84(7):744\u20138.","journal-title":"Am J Gastroenterol"},{"issue":"2","key":"1609_CR13","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1002\/ibd.20282","volume":"14","author":"PD Headstrom","year":"2008","unstructured":"Headstrom PD, Rulyak SJ, Lee SD. Prevalence of and risk factors for vitamin B(12) deficiency in patients with Crohn\u2019s disease. Inflamm Bowel Dis. 2008;14(2):217\u201323.","journal-title":"Inflamm Bowel Dis"},{"issue":"1","key":"1609_CR14","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1016\/S0002-8223(21)08097-4","volume":"84","author":"P Hodges","year":"1984","unstructured":"Hodges P, Gee M, Grace M, Thomson AB. Vitamin and iron intake in patients with Crohn\u2019s disease. J Am Diet Assoc. 1984;84(1):52\u20138.","journal-title":"J Am Diet Assoc"},{"issue":"8","key":"1609_CR15","doi-asserted-by":"publisher","first-page":"1190","DOI":"10.1136\/gut.2003.035758","volume":"53","author":"C Gasche","year":"2004","unstructured":"Gasche C, Lomer MC, Cavill I, Weiss G. Iron, anaemia, and inflammatory bowel diseases. Gut. 2004;53(8):1190\u20137.","journal-title":"Gut"},{"issue":"6","key":"1609_CR16","doi-asserted-by":"publisher","first-page":"750","DOI":"10.5009\/gnl14193","volume":"9","author":"B Kim","year":"2015","unstructured":"Kim B, Park SJ, Hong SP, Cheon JH, Kim TI, Kim WH. Overlooked management and risk factors for anemia in patients with intestinal Behcet\u2019s disease in actual clinical practice. Gut Liv. 2015;9(6):750\u20135.","journal-title":"Gut Liv"},{"issue":"6","key":"1609_CR17","doi-asserted-by":"publisher","first-page":"576","DOI":"10.1097\/MCO.0000000000000226","volume":"18","author":"R Weisshof","year":"2015","unstructured":"Weisshof R, Chermesh I. Micronutrient deficiencies in inflammatory bowel disease. Curr Opin Clin Nutr Metab Care. 2015;18(6):576\u201381.","journal-title":"Curr Opin Clin Nutr Metab Care"},{"issue":"11","key":"1609_CR18","doi-asserted-by":"publisher","first-page":"1272","DOI":"10.3109\/00365521.2013.836752","volume":"48","author":"F Bermejo","year":"2013","unstructured":"Bermejo F, Algaba A, Guerra I, Chaparro M, De-La-Poza G, Valer P, Piqueras B, Bermejo A, Garcia-Alonso J, Perez MJ, et al. Should we monitor vitamin B12 and folate levels in Crohn\u2019s disease patients? Scand J Gastroenterol. 2013;48(11):1272\u20137.","journal-title":"Scand J Gastroenterol"},{"issue":"4","key":"1609_CR19","doi-asserted-by":"publisher","first-page":"320","DOI":"10.1016\/j.ejim.2010.05.007","volume":"21","author":"M Yakut","year":"2010","unstructured":"Yakut M, Ustun Y, Kabacam G, Soykan I. Serum vitamin B12 and folate status in patients with inflammatory bowel diseases. Eur J Intern Med. 2010;21(4):320\u20133.","journal-title":"Eur J Intern Med"},{"issue":"10","key":"1609_CR20","doi-asserted-by":"publisher","first-page":"3085","DOI":"10.1007\/s10620-015-3727-4","volume":"60","author":"M Torki","year":"2015","unstructured":"Torki M, Gholamrezaei A, Mirbagher L, Danesh M, Kheiri S, Emami MH. Vitamin D deficiency associated with disease activity in patients with inflammatory bowel diseases. Dig Dis Sci. 2015;60(10):3085\u201391.","journal-title":"Dig Dis Sci"},{"issue":"9","key":"1609_CR21","first-page":"1921","volume":"19","author":"AN Ananthakrishnan","year":"2013","unstructured":"Ananthakrishnan AN, Cagan A, Gainer VS, Cai T, Cheng SC, Savova G, Chen P, Szolovits P, Xia Z, De Jager PL, et al. Normalization of plasma 25-hydroxy vitamin D is associated with reduced risk of surgery in Crohn\u2019s disease. Inflamm Bowel Dis. 2013;19(9):1921\u20137.","journal-title":"Inflamm Bowel Dis"},{"issue":"7","key":"1609_CR22","doi-asserted-by":"publisher","first-page":"889","DOI":"10.1038\/sj.ejcn.1602395","volume":"60","author":"J Gilman","year":"2006","unstructured":"Gilman J, Shanahan F, Cashman KD. Determinants of vitamin D status in adult Crohn\u2019s disease patients, with particular emphasis on supplemental vitamin D use. Eur J Clin Nutr. 2006;60(7):889\u201396.","journal-title":"Eur J Clin Nutr"},{"issue":"3","key":"1609_CR23","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1097\/01.MIB.0000206541.15963.c3","volume":"12","author":"J Filippi","year":"2006","unstructured":"Filippi J, Al-Jaouni R, Wiroth JB, Hebuterne X, Schneider SM. Nutritional deficiencies in patients with Crohn\u2019s disease in remission. Inflamm Bowel Dis. 2006;12(3):185\u201391.","journal-title":"Inflamm Bowel Dis"},{"issue":"4","key":"1609_CR24","doi-asserted-by":"publisher","first-page":"311","DOI":"10.1177\/0148607107031004311","volume":"31","author":"K Vagianos","year":"2007","unstructured":"Vagianos K, Bector S, McConnell J, Bernstein CN. Nutrition assessment of patients with inflammatory bowel disease. JPEN J Parenter Enteral Nutr. 2007;31(4):311\u20139.","journal-title":"JPEN J Parenter Enteral Nutr"},{"issue":"4","key":"1609_CR25","doi-asserted-by":"publisher","first-page":"718","DOI":"10.1002\/ibd.21785","volume":"18","author":"K Vagianos","year":"2012","unstructured":"Vagianos K, Bernstein CN. Homocysteinemia and B vitamin status among adult patients with inflammatory bowel disease: a one-year prospective follow-up study. Inflamm Bowel Dis. 2012;18(4):718\u201324.","journal-title":"Inflamm Bowel Dis"},{"issue":"8","key":"1609_CR26","doi-asserted-by":"publisher","first-page":"473","DOI":"10.1155\/2003\/391308","volume":"17","author":"JS Siffledeen","year":"2003","unstructured":"Siffledeen JS, Siminoski K, Steinhart H, Greenberg G, Fedorak RN. The frequency of vitamin D deficiency in adults with Crohn\u2019s disease. Can J Gastroenterol. 2003;17(8):473\u20138.","journal-title":"Can J Gastroenterol"},{"issue":"5","key":"1609_CR27","doi-asserted-by":"publisher","first-page":"1077","DOI":"10.1093\/ajcn\/76.5.1077","volume":"76","author":"TA Sentongo","year":"2002","unstructured":"Sentongo TA, Semaeo EJ, Stettler N, Piccoli DA, Stallings VA, Zemel BS. Vitamin D status in children, adolescents, and young adults with Crohn disease. Am J Clin Nutr. 2002;76(5):1077\u201381.","journal-title":"Am J Clin Nutr"},{"issue":"6","key":"1609_CR28","doi-asserted-by":"publisher","first-page":"1451","DOI":"10.1111\/j.1572-0241.2007.01753.x","volume":"103","author":"WD Leslie","year":"2008","unstructured":"Leslie WD, Miller N, Rogala L, Bernstein CN. Vitamin D status and bone density in recently diagnosed inflammatory bowel disease: the Manitoba IBD Cohort Study. Am J Gastroenterol. 2008;103(6):1451\u20139.","journal-title":"Am J Gastroenterol"},{"issue":"8","key":"1609_CR29","doi-asserted-by":"publisher","first-page":"797","DOI":"10.1097\/00054725-200608000-00016","volume":"12","author":"GR Lichtenstein","year":"2006","unstructured":"Lichtenstein GR, Sands BE, Pazianas M. Prevention and treatment of osteoporosis in inflammatory bowel disease. Inflamm Bowel Dis. 2006;12(8):797\u2013813.","journal-title":"Inflamm Bowel Dis"},{"issue":"3","key":"1609_CR30","doi-asserted-by":"publisher","first-page":"116","DOI":"10.1007\/s11914-996-0031-4","volume":"4","author":"CN Bernstein","year":"2006","unstructured":"Bernstein CN. Inflammatory bowel diseases as secondary causes of osteoporosis. Curr Osteoporosis Rep. 2006;4(3):116\u201323.","journal-title":"Curr Osteoporosis Rep"},{"issue":"11\u201312","key":"1609_CR31","doi-asserted-by":"publisher","first-page":"1507","DOI":"10.1111\/j.1365-2036.2006.03146.x","volume":"24","author":"S Kulnigg","year":"2006","unstructured":"Kulnigg S, Gasche C. Systematic review: managing anaemia in Crohn\u2019s disease. Aliment Pharmacol Ther. 2006;24(11\u201312):1507\u201323.","journal-title":"Aliment Pharmacol Ther"},{"issue":"1","key":"1609_CR32","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1111\/1751-2980.12565","volume":"19","author":"H Schaffler","year":"2018","unstructured":"Schaffler H, Schmidt M, Huth A, Reiner J, Glass A, Lamprecht G. Clinical factors are associated with vitamin D levels in IBD patients: a retrospective analysis. J Dig Dis. 2018;19(1):24\u201332.","journal-title":"J Dig Dis"},{"issue":"6","key":"1609_CR33","first-page":"1120","volume":"20","author":"R Battat","year":"2014","unstructured":"Battat R, Kopylov U, Szilagyi A, Saxena A, Rosenblatt DS, Warner M, Bessissow T, Seidman E, Bitton A. Vitamin B12 deficiency in inflammatory bowel disease: prevalence, risk factors, evaluation, and management. Inflamm Bowel Dis. 2014;20(6):1120\u20138.","journal-title":"Inflamm Bowel Dis"}],"container-title":["BMC Gastroenterology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12876-021-01609-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/s12876-021-01609-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12876-021-01609-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,12]],"date-time":"2022-12-12T10:57:05Z","timestamp":1670842625000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcgastroenterol.biomedcentral.com\/articles\/10.1186\/s12876-021-01609-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1,21]]},"references-count":33,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["1609"],"URL":"https:\/\/doi.org\/10.1186\/s12876-021-01609-8","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-77067\/v1","asserted-by":"object"}]},"ISSN":["1471-230X"],"issn-type":[{"value":"1471-230X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,1,21]]},"assertion":[{"value":"17 September 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 January 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 January 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"This study was performed in accordance with the ethical guidelines of the 1975 Declaration of Helsinki and was approved by the institutional review board of Severance Hospital (2020-1271-001).","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not Applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no conflict of interest.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"32"}}