Digestive Disease and Nutrition Center, SUNY at Buffalo, Buffalo, NY, USA.
J Pediatr Gastroenterol Nutr. 2013 Jan;56(1):89-92. doi: 10.1097/MPG.0b013e31826a105d.
Patients with inflammatory bowel disease (IBD) are at risk for vitamin and mineral deficiencies because of long-term inflammation in the gut mucosa and decreased oral intake. The aim of the study is to investigate the prevalence of vitamin and zinc deficiencies in patients with newly diagnosed IBD compared with a control group.
This is a retrospective chart review of all of the patients diagnosed as having IBD from 2006 to 2010, ages 1 to 18 years. Patients who had fat- and water-soluble vitamins (A, E, D 25-OH, folate, and B(12)) and zinc levels obtained at time of diagnosis were included in the study. A total of 61 patients with IBD and 61 age- and sex-matched controls were included.
None of the 61 patients with IBD had folate or vitamin B12 deficiency. Vitamin D deficiency was found in 62% of the patients, vitamin A deficiency in 16%, vitamin E deficiency in 5%, and zinc deficiency in 40%. The control group had vitamin D and E and zinc deficiency in 75%, 8%, and 19% patients, respectively.
We conclude that vitamin B12 and folate deficiencies are rare in children with newly diagnosed IBD in the United States and we question whether routine monitoring is warranted. Vitamin A and zinc deficiency are common in patients with newly diagnosed IBD and levels should be assessed at the time of diagnosis so that enteral repletion can commence. Vitamin D deficiency is common in all of the children in the Buffalo, NY, area, and routine screening for this deficiency is warranted.
由于肠道黏膜长期炎症和口服摄入减少,炎症性肠病(IBD)患者存在维生素和矿物质缺乏的风险。本研究旨在调查与对照组相比,新诊断的 IBD 患者维生素和锌缺乏的发生率。
这是一项对 2006 年至 2010 年期间诊断为 IBD 的所有 1 至 18 岁患者的回顾性图表审查。将在诊断时获得脂溶性和水溶性维生素(A、E、D25-OH、叶酸和 B12)和锌水平的患者纳入研究。共有 61 例 IBD 患者和 61 名年龄和性别匹配的对照者纳入本研究。
61 例 IBD 患者中均无叶酸或维生素 B12 缺乏。62%的患者存在维生素 D 缺乏,16%的患者存在维生素 A 缺乏,5%的患者存在维生素 E 缺乏,40%的患者存在锌缺乏。对照组中维生素 D、E 和锌缺乏的患者分别占 75%、8%和 19%。
我们得出结论,美国新诊断的 IBD 儿童中维生素 B12 和叶酸缺乏罕见,我们质疑是否需要常规监测。新诊断的 IBD 患者中维生素 A 和锌缺乏常见,应在诊断时评估其水平,以便开始肠内补充。维生素 D 缺乏在纽约州布法罗地区的所有儿童中都很常见,因此有必要进行常规筛查。