Nutritional Status and Growth in Korean Children with Crohn’s Disease: A Single-Center Study

Abstract

Background/AimsMalnutrition and growth retardation are important issues in treating pediatric Crohn’s disease (CD). Thus, we aimed to investigate the prevalence of various nutritional and growth parameters at the time of diagnosis in Korean children with CD.MethodsSeventy-one children (<18 years) were enrolled. We analyzed the Z-scores of height-for-age (HAZ), weight-for-height (WHZ), body mass index for age (BMIZ), bone mineral density for age (BMDZ), and the biochemical markers measured at the time of diagnosis.ResultsAt diagnosis, HAZ <−2 was observed in three patients (4%), WHZ <−2 in 20 patients (28%), BMIZ <−2 in 19 patients (27%), and BMDZ <−2 in 11 patients (18%). The HAZ was significantly lower in females and patients with extraintestinal manifestations, and the WHZ and BMIZ were significantly lower in patients with stricturing and penetrating disease. Subnormal serum levels were highly prevalent for hemoglobin, albumin, iron, ferritin, calcium, magnesium, folate, vitamin B12, and zinc. There was a significant correlation between nutritional status, growth retardation, and disease activity.ConclusionsAbnormal nutritional status was highly prevalent in Korean children with CD at the time of diagnosis and was associated with the extent, behavior, and activity of the disease.

Serum Concentrations of Trace Elements in Patients with Ulcerative Colitis

“…Aghazadeh et al claimed that the intake of fluids, Mg and vitamin C is lower in IBD patients than in healthy people [19]. In a study conducted in 2014, Song et al reported that 72% of patients had micronutrients deficiency and about 10% of Crohn's disease patients were Mg deficient [7]. In our study, the mean serum level of Mg was significantly higher in the control group.…”

“…In IBD cases, altered metabolism of minerals occurs mostly during flare-ups. Trace elements particularly copper (Cu) and zinc (Zn), may affect ability of mucosa in dealing with harmful effects of free radicals [7]. Zn is an antioxidant element essential for biological functions, homeostasis, metabolism, absorption and intracellular transport in enterocytes and hepatocytes.…”

“…Regulation of muscle contraction, blood pressure, insulin metabolism, cardiac irritability, nerve conduction and neuromuscular transmission are all among the most important functions of Mg [11]. Selenium (Se) can induce apoptosis and prevent mutations induced by free radicals and carcinogenic metabolites in form of glutathione peroxidase and selenoproteins [7]. Dietary Se affects the intestinal microbial composition and adjustment of various prostaglandins, which reduces reactive oxygen species [2].…”

Micronutrient Deficiencies in Children With Inflammatory Bowel Diseases

“…Other smaller cohorts found that zinc was deficient in up to 20% of patients, mainly in those with CD. Only 1 study reported a similar prevalence of 51% in newly diagnosed patients with CD. Zinc deficiency in patients with IBD may be attributed to low oral intake or poor absorption.…”

“…It was demonstrated in previous studies that iron deficiency is very common in patients with IBD, even under complete clinical remission, and iron sufficiency is often not sustainable following iron treatment due to ongoing inflammatory activity. 3,6 According to other studies, 14,16,[21][22][23] up to 90% of patients with IBD will have iron deficiency at presentation. This extremely high prevalence of iron deficiency at diagnosis is attributed to many known factors, such as decreased intake, gastrointestinal bleeding and iron loss, decreased absorption capacity, as well as chronic inflammation.…”