Micronutrient Deficiencies in Children with Inflammatory Bowel Diseases

Introduction:

Children with inflammatory bowel diseases (IBD) are at risk of developing nutritional deficiencies, due to malnutrition, chronic diarrhea and restricted diets. This study was aimed to assess the status of specific trace elements, minerals and vitamins in a large cohort of children.

Methods:

The medical records of children diagnosed with IBD between 2000 to 2016 were reviewed retrospectively. Retrieved data included demographic variables, disease characteristics, disease activity indices, and trace elements, minerals and vitamins at diagnosis and during follow-up.

Results:

Out of 359 children with IBD (102 females, 44%), 237 (66%) were diagnosed with Crohn`s disease (CD). The prevalence of nutrients` deficiencies in the CD group at diagnosis, and last follow-up, were: Zinc (53% and 11.5%), vitamin D (47.8% and 42%), Iron (88% and 39.5%) and Folic acid (10 % and 13%). The prevalence of nutrients` deficiencies in the UC group at diagnosis, and last follow-up, were: Zinc (31% and 10%), vitamin D (51% and 39%), Iron (77% and 40%) and Folic acid (3.8 % and 9.7%).. Magnesium and Vitamin B12 deficiencies were extremely rare in both UC and CD . Active disease 1 year after diagnosis, was associated with low iron levels (p<0.004) in patients with CD and low zinc (p<0.031) and vitamin D (p<0.018) in patients with UC.

Conclusions:

In children with IBD, deficiencies in iron, zinc and vitamin D are common at diagnosis with only limited improvement during follow-up. Deficiencies in magnesium and vitamin B12 are extremely rare and should not be monitored routinely