Song Seung Min, Kim Young, Oh Seak Hee, Kim Kyung Mo
Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Korea.
Gut Liver. 2014 Sep;8(5):500-7. doi: 10.5009/gnl13183. Epub 2014 Apr 23.
BACKGROUND/AIMS: Malnutrition 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.
Seventy-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.
At 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.
Abnormal 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.
背景/目的:营养不良和生长发育迟缓是小儿克罗恩病(CD)治疗中的重要问题。因此,我们旨在调查韩国CD患儿诊断时各种营养和生长参数的患病率。
纳入71名18岁以下儿童。我们分析了年龄别身高(HAZ)、身高别体重(WHZ)、年龄别体重指数(BMIZ)、年龄别骨密度(BMDZ)的Z评分以及诊断时测量的生化指标。
诊断时,3例患者(4%)的HAZ<-2,20例患者(28%)的WHZ<-2,19例患者(27%)的BMIZ<-2,11例患者(18%)的BMDZ<-2。女性和有肠外表现的患者HAZ显著更低,狭窄型和穿透型疾病患者的WHZ和BMIZ显著更低。血红蛋白、白蛋白、铁、铁蛋白、钙、镁、叶酸、维生素B12和锌的血清水平低于正常很常见。营养状况、生长发育迟缓与疾病活动之间存在显著相关性。
韩国CD患儿诊断时营养状况异常很常见,且与疾病的范围、行为和活动相关。