Hair Mineral and Trace Element Contents as Reliable Markers of Nutritional Status Compared to Serum Levels of These Elements in Children Newly Diagnosed with Inflammatory Bowel Disease

Abstract

Patients with inflammatory bowel disease (IBD) are at high risk for nutritional deficiencies because of long-term inflammation in the gut mucosa and decreased oral intake. Because inflammation responses affect serum micronutrient concentrations, serum levels are limited in reflecting body nutrient status in acute and chronic illness. We investigated the usefulness of measuring trace elements in hair as reliable markers of nutritional status compared to serum levels in children with IBD. We retrospectively analyzed pediatric patients newly diagnosed with Crohn's disease (n = 49) and ulcerative colitis (n = 16) and controls (n = 29) from 2012 to 2016. Serum micronutrient levels, inflammatory markers, and hair trace element content were evaluated and compared at the time of diagnosis and before initiating treatment. Serum calcium (p < 0.001), iron (p < 0.001), zinc (p = 0.013), selenium (p = 0.008), albumin (p < 0.001), prealbumin (p < 0.001), hemoglobin and hematocrit (p < 0.001), and WBC (p = 0.001) and lymphocytes (p < 0.001) differed significantly between the groups. After adjustment for the erythrocyte sedimentation rate, serum zinc and selenium levels were no longer significantly different between the groups (p < 0.062 and p < 0.057, respectively). Following hair analysis for mineral and trace elements, iron (p = 0.033), selenium (p = 0.017), and manganese (p = 0.009) differed significantly between the groups. Serum micronutrient levels need cautious interpretation in conjunction with inflammatory markers. Hair mineral and trace element measurement may support understanding micronutrient status in children with IBD.

Selenium and mercury in the hair of raccoons (Procyon lotor) and European wildcats (Felis s. silvestris) from Germany and Luxembourg

“…For example, Górski et al (2018) found that increase oral intake of Se caused a significant increase (p ≤ 0.05) in the Se concentration in the hair of animals. In turn, Cho and Yang (2018), based on their observation, suggested that hair better reflects Se status in organism than serum and therefore they recommend use of hair, as one of matrixes, to full analysis of selenium status. In addition, significant correlations between Se and Hg in hair was reported (Soares de Campos et al 2002).…”

New Insights into the Role of Trace Elements in IBD

“…Among the consequences of dietary changes, restrictive diets, and absorption deficiencies, malnutrition, whether it only includes protein malnutrition or micronutrient deficiencies as well, is a frequent diagnosis that can persist further on, as a consequence of altered intake, use of various drugs, or hypercatabolic state in this patient category [ 2 ].…”

“…Most micronutrient status evaluations were performed by assessing serum levels [ 13 , 14 ], although the presence of chronic inflammation determines a high variability among these, independently of tissue stores [ 15 , 16 ]. Consequently, serum levels do not offer an accurate measure of trace element stores and trace element levels in hair have been proposed as a more reliable measurement of the chronic microelement nutritional status, considering that the systemic inflammatory response has been shown to independently decrease serum levels of micronutrients, including zinc, selenium, copper, and various vitamins, without any correlation to the actual nutritional status [ 2 ].…”

Quantitative assessment of nutrition and nutritional status of patients with Crohn’s disease aged 13–18

“…The morphological parameters of the blood were mostly normal, with the exception of low hemoglobin and hematocrit, and elevated monocyte counts in girls. Studies by Cho and Yang also indicate reduced parameters of hemoglobin and hematocrit in newly diagnosed patients [38]. Elevated monocytes were also observed in the study by Szczuko et al [39].…”