Nutritional status in patients with ulcerative colitis in Isfahan, Iran

Kalantari, Hossein; Barekat, S M; Maracy, Mohammad Reza; Azadbakht, Leila; Shahshahan, Zahra

doi:10.4103/2277-9175.125812

Cited by 8 publications

(7 citation statements)

References 28 publications

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“…In this study, vitamin D was deficient in 73.8% of patients with IBD being the second most frequent micronutrient deficiency after iron deficiency. Kalantari et al [ 2 ] also reported a higher prevalence of vitamin D deficiency in their pediatric patients with UC (87%). Nonetheless, this prevalence is still considered low compared to that of healthy age-matched counterpart children in Bahrain where vitamin D deficiency prevalence is extremely high (93.4%) [ 45 ].…”

Section: Discussionmentioning

confidence: 98%

“…Motil et al [ 40 ] study showed no significant difference in vitamin B12 levels between children with CD and those with UC. Yet, Kalantari et al [ 2 ] reported a remarkably high proportion of vitamin B12 deficiency in adult patients with mild and moderate to severe UC (35% and 50%, respectively). Fritz et al stated that screening for vitamin B12 deficiency should be limited to patients with ileal or ileocolonic resection, and those with suspected malabsorption [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

“…Crohn's disease (CD), ulcerative colitis (UC), and indeterminate colitis are chronic diseases of the gastrointestinal tract known as inflammatory bowel diseases (IBD) [1][2][3][4][5][6][7][8]. IBD may present at any age [6].…”

Section: Introductionmentioning

confidence: 99%

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The Prevalence of Iron and Vitamin D Deficiencies in Pediatric Patients With Inflammatory Bowel Disease in Bahrain

Isa¹,

Alahmed²,

Mohamed³

et al. 2023

Cureus

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IntroductionInflammatory bowel diseases (IBD) are chronic diseases that can affect nutrient absorption leading to micronutrient deficiencies and biochemical abnormalities. This study aimed to assess certain serum micronutrients and nutritionally related biochemical markers levels in patients with pediatric IBD and to compare the actual levels and the prevalence of micronutrients deficiencies and biochemical abnormalities between patients with Crohn's disease (CD) and those with ulcerative colitis (UC). MethodsA retrospective cross-sectional study reviewing medical records of patients with IBD was conducted in the pediatric department, Salmaniya medical complex, Bahrain, from 1 January 1984 to 31 December 2021. Demographic data and laboratory results related to micronutrients and biochemical markers including full blood count, total protein, albumin, globulin, iron, ferritin, folic acid, vitamin B12, calcium, phosphorous, magnesium, and vitamin D levels were collected upon presentation before starting the treatment. Nutritional deficiencies were compared based on sex, nationality, type of IBD, age at presentation, disease duration, weight at diagnosis, and inflammatory markers levels including erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). ResultsOf 157 patients with pediatric IBD, 117 (74.5%) were included. Sixty-six (56.4%) patients were males. Sixtysix (56.4%) had CD and 51 (43.6%) had UC. No patient had indeterminant colitis. The mean age at presentation was 10.8±3.8 years. Most patients had one or more micronutrient deficiencies (n=110, 94%). Anemia was a common finding (n=79/116, 68.1%), with iron deficiency anemia (IDA) being predominant. Low iron levels were noted in 64/77 (83.1%) patients with a median of 5.0 (2.0-9.3) µmol/L (normal range, 11.6-31.3); isolated iron deficiency (ID) in 11/18 (61.1%) and IDA in 53/59 (89.8%) patients. Vitamin D deficiency was the second most common (n=45/61, 73.8%). Serum albumin, ferritin, calcium, phosphorous, and magnesium were deficient in 29.2%, 27.8%, 31.7%, 12.5%, and 10%, respectively. One patient had vitamin B12 deficiency while none had folate deficiency. Patients with CD had significantly lower serum iron (5.4±5.6 versus 8.1±6.09 µmol//L, p=0.02) and lower serum protein (71.7±8.7 versus 75.4±9.9 g/L, p=0.043) but higher serum ferritin (45 (19-110.2) versus 21.3 (10.3-51.2) µg/L, p=0.046) compared to those with UC. Elevated ESR was noted in 62/105 (59.1%) patients while high CRP was found in 67/104 (64.4%). Patients with low iron had higher ESR (28 (17-47) versus 14 (10-33) mm/h, p=0.028) and higher CRP (13.3 (1.6-42) versus 1.8 (0.9-4.6) mg/L, p=0.019) levels compared to those with normal levels. ConclusionPatients with pediatric IBD are at risk of multiple micronutrient deficiencies and biochemical abnormalities. Iron and vitamin D deficiencies are the most frequent. Patients with CD are more prone to have lower serum iron and protein levels than those with UC. ID was associated with elevated inflammatory markers.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

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The Prevalence of Iron and Vitamin D Deficiencies in Pediatric Patients With Inflammatory Bowel Disease in Bahrain

Isa¹,

Alahmed²,

Mohamed³

et al. 2023

Cureus

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“…Malnutrition is present in the vast majority of patients with inflammatory bowel disease (IBD), the deficiencies being more prevalent in Crohn’s disease compared with ulcerative colitis and more important in active diseases [68]. Micronutrient deficiencies are essentially explained by the reduced dietary intake and the underlying malabsorption.…”

Section: Disease Specific Deficiencymentioning

confidence: 99%

Micronutrient Deficiencies in Medical and Surgical Inpatients

Berger

Pantet

Schneider

et al. 2019

JCM

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Inpatients are threatened by global malnutrition, but also by specific micronutrient (i.e., trace element and vitamins) deficiencies that frequently are overseen in the differential diagnosis of major organ dysfunctions. Some of them are related to specific geographic risks (iodine, iron, selenium, zinc, vitamin A), while others are pathology related, and finally many are associated with specific feeding patterns, including low dose enteral feeding. Among the pathologies in which laboratory blood investigations should include a micronutrient outwork, anemia is in the front line, followed by obesity with bariatric surgery, chronic liver disease, kidney disease, inflammatory bowel disease, cardiomyopathies and heart failure. The micronutrients at the highest risk are iron, zinc, thiamine, vitamin B12 and vitamin C. Admission to hospital has been linked with an additional risk of malnutrition—feeding below 1500 kcal/day was frequent and has been associated with a structural additional risk of insufficient micronutrient intake to cover basal needs. Although not evidence based, systematic administration of liberal thiamine doses upon admission, and daily complementation of inpatients’ food and enteral feeding solutions with multi-micronutrient tablets might be considered.

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“…On the other hand, inadequate nutritional support in these patients can result in deterioration of nutritional status and progress of malnutrition during hospitalization. [ 15 16 17 ] In summary, nutritional status monitoring and optimal nutritional delivery are essential practice in the critically ill patients which can reduce morbidity, mortality, and hospitalization costs. [ 18 19 ]…”

Section: Introductionmentioning

confidence: 99%

Comparison of Energy and Nutrient Contents of Commercial and Noncommercial Enteral Nutrition Solutions

et al. 2017

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Background:Nutritional support plays a major role in the management of critically ill patients. This study aimed to compare the nutritional quality of enteral nutrition solutions (noncommercial vs. commercial) and the amount of energy and nutrients delivered and required in patients receiving these solutions.Materials and Methods:This cross-sectional study was conducted among 270 enterally fed patients. Demographic and clinical data in addition to values of nutritional needs and intakes were collected. Moreover, enteral nutrition solutions were analyzed in a food laboratory.Results:There were 150 patients who fed noncommercial enteral nutrition solutions (NCENS) and 120 patients who fed commercial enteral nutrition solutions (CENSs). Although energy and nutrients contents in CENSs were more than in NCENSs, these differences regarding energy, protein, carbohydrates, phosphorus, and calcium were not statistically significant. The values of energy and macronutrients delivered in patients who fed CENSs were higher (P < 0.001). Energy, carbohydrate, and fat required in patients receiving CENSs were provided, but protein intake was less than the required amount. In patients who fed NCENSs, only the values of fat requirement and intake were not significantly different, but other nutrition delivered was less than required amounts (P < 0.001). CENSs provided the nutritional needs of higher numbers of patients (P < 0.001). In patients receiving CENSs, nutrient adequacy ratio and also mean adequacy ratio were significantly higher than the other group (P < 0.001).Conclusion:CENSs contain more energy and nutrients compared with NCENSs. They are more effective to meet the nutritional requirements of entirely fed patients.

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Nutritional status in patients with ulcerative colitis in Isfahan, Iran

Cited by 8 publications

References 28 publications

The Prevalence of Iron and Vitamin D Deficiencies in Pediatric Patients With Inflammatory Bowel Disease in Bahrain

The Prevalence of Iron and Vitamin D Deficiencies in Pediatric Patients With Inflammatory Bowel Disease in Bahrain

Micronutrient Deficiencies in Medical and Surgical Inpatients

Comparison of Energy and Nutrient Contents of Commercial and Noncommercial Enteral Nutrition Solutions

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