Evidence map›Paper›PMID 39804874›Full record

SynthesisPloS one2025

Iron deficiency and fatigue in inflammatory bowel disease: A systematic review.

Stephanie Sartain, Maryam Al-Ezairej, Martin McDonnell, Catherine Westoby, Vasiliki Katarachia, Stephen A Wootton, J R Fraser Cummings

Abstract readSystematic Review
In one paragraph

Synthesis in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Stephanie SartainDepartment of Gastroenterology, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom.ORCID 0000-0001-6910-1596
Maryam Al-EzairejUniversity Hospitals of Leicester NHS Trust, Leicester, United Kingdom.ORCID 0009-0001-2380-4621
Martin McDonnellDepartment of Gastroenterology, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom.
Catherine WestobyDepartment of Gastroenterology, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom.
Vasiliki KatarachiaDepartment of Gastroenterology, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom.
Stephen A WoottonSchool of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, United Kingdom.
J R Fraser CummingsDepartment of Gastroenterology, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIt is unclear what impact iron deficiency has on fatigue in people with inflammatory bowel disease (IBD). This systematic review examined the evidence of whether iron deficiency, with or without anaemia, was associated with fatigue in IBD. Fatigue is a common symptom in patients with IBD that can be difficult to manage and treat. A greater understanding of the role and contribution of iron deficiency to fatigue may help improve the management of this condition.

methodsThe databases searched were MEDLINE, OVID, CINAHL and Web of Science. Inclusion criteria were studies measuring iron status for iron deficiency (ID) and patient-reported outcome measures (PROMs) for fatigue in patients with IBD of any level of disease activity. Assessment of bias was conducted using the Newcastle Ottawa Scale. Studies were grouped for syntheses according to whether exposure was iron deficiency without anaemia (IDWA) or ID regardless of haemoglobin level.

resultsTwo hundred and eighty-five individual database results were identified and screened; 32 complete records were reviewed, from which seven studies with 1425 individuals were deemed eligible for inclusion in the results synthesis. Considerable variation in the methods and statistical analysis used to investigate the relationship between ID and fatigue prevented any quantitative synthesis. Studies varied by population disease activity levels, approaches used to define ID and PROMs used to measure fatigue. Three studies directly compared fatigue scores in IDWA to those not iron deficient, two of which showed patients with IDWA had significantly lower fatigue scores. Four studies used ID irrespective of anaemia as the exposure and reported mixed results on fatigue, with only one study reporting a higher prevalence of fatigue in the ID group.

conclusionsThere was marked heterogeneity between studies in this review. Two studies found evidence of a slight increase in fatigue levels in patients with IDWA. Though this does not explain all fatigue in patients with IBD, iron replacement should be considered to improve fatigue in iron-deficient patients.

Indexed as

Anemia, Iron-DeficiencyFatigueInflammatory Bowel DiseasesIron DeficienciesHumansIronIron

Identifiers

PMID39804874
PMCPMC11730394

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.