Abstract Background/objective Crohn’s Disease (CD) is a chronic inflammatory bowel disease that affects micronutrient levels, impacting metabolic pathways. Homocysteine (Hcy) levels, regulated by folate and vitamin B12, are associated with cardiovascular and extraintestinal manifestations (EIMs). This study aims to analyze the dietary intake and serum concentrations of folate and vitamin B12 and their relationship with systemic complications in patients with CD in remission and active phases. Methods This cross-sectional study included 60 patients, and nutrient intake was stratified into tertiles by disease phase. The metabolic safety of folate and B12 was evaluated by characterizing metabolic risk patterns associated with elevated Hcy. Statistical analyses evaluated associations between dietary intake, metabolic safety, and disease phenotype. Results Vitamin B12 intake was negatively associated with erythrocyte sedimentation rate and positively associated with the absence of EIMs. Serum folate and non-HDL cholesterol levels were lower in the active group. Clinical vitamin B12 deficiency was more frequent in active disease, contributing to an elevated Hcy risk. Stricturing/penetrating phenotypes showed lower vitamin B12 levels compared to non-stricturing, non-penetrating phenotypes. Additionally, 96% of patients with structuring/penetrating disease were at high Hcy risk, while 30% of patients with non-stricturing, non-penetrating disease were in the lowest risk category. Conclusions The data suggest that folate and B12 levels could be markers for clinical characteristics and associated metabolic risk in patients with CD. Our study highlighted associations that may justify the importance of nutritional follow-up and biochemical assessments in the clinical routine of patients with CD.
Castro et al. (2026) studied this question.