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儿童炎症性肠病中的微量营养素缺乏。

Micronutrient Deficiencies in Children With Inflammatory Bowel Diseases.

机构信息

Institute of Gastroenterology, Nutrition and Liver Disease, Schneider Children's Medical Center, Petach Tikva, Israel.

Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

出版信息

Nutr Clin Pract. 2020 Apr;35(2):315-322. doi: 10.1002/ncp.10373. Epub 2019 Jul 25.

Abstract

BACKGROUND

Children with inflammatory bowel diseases (IBDs) are at risk of developing nutrition deficiencies, particularly because of reduced intake, restrictive diets, malabsorption, and excessive nutrient loss. In this study, we aimed to assess the status of trace elements, minerals, and vitamins in a large cohort of children with IBDs.

METHODS

Medical records of children diagnosed with IBDs during 2000-2016 were reviewed retrospectively. Retrieved data included demographics, disease characteristics, disease activity indices, anthropometric measures, and specific trace elements, minerals, and vitamins at diagnosis and during follow-up.

RESULTS

Out of 359 children with IBD (158 [44%] females, median age at diagnosis 14.1 years, interquartile range [IQR] 12.0-16.0), 240 (67%) were diagnosed with Crohn's disease (CD) and 119 (33%) with ulcerative colitis (UC). Median follow-up time was 7 years (IQR 5-10). The prevalence of deficiencies in patients with CD at diagnosis and last follow-up, respectively, were iron (88% and 39.5%), zinc (53% and 11.5%), vitamin D (39% and 36%), and folic acid (10% and 13%). In patients with UC, frequencies were: iron (77% and 40%), vitamin D (49% and 33%), zinc (31% and 10%), and folic acid (3.8% and 9.7%). Magnesium and vitamin B12 deficiencies were rare. For both diseases, iron deficiency was associated with hypoalbuminemia. Deficiencies in iron and zinc were more common in patients with CD than those with UC.

CONCLUSIONS

Deficiencies in iron, zinc, and vitamin D are common at pediatric IBD diagnosis with limited improvement during follow-up, whereas deficiencies in magnesium and vitamin B12 are rare.

摘要

背景

患有炎症性肠病(IBD)的儿童有出现营养缺乏的风险,特别是由于摄入减少、饮食限制、吸收不良和过度营养素丢失。在这项研究中,我们旨在评估大量 IBD 患儿的微量元素、矿物质和维生素状况。

方法

回顾性分析 2000 年至 2016 年间诊断为 IBD 的儿童的病历。检索的数据包括人口统计学、疾病特征、疾病活动指数、人体测量指标以及诊断和随访时的特定微量元素、矿物质和维生素。

结果

359 名患有 IBD 的儿童(158 名[44%]女性,中位诊断年龄为 14.1 岁,四分位间距[IQR]12.0-16.0),240 名(67%)诊断为克罗恩病(CD),119 名(33%)诊断为溃疡性结肠炎(UC)。中位随访时间为 7 年(IQR 5-10)。分别在 CD 诊断时和最后一次随访时,患者缺乏症的患病率为铁(88%和 39.5%)、锌(53%和 11.5%)、维生素 D(39%和 36%)和叶酸(10%和 13%)。UC 患者的频率分别为:铁(77%和 40%)、维生素 D(49%和 33%)、锌(31%和 10%)和叶酸(3.8%和 9.7%)。镁和维生素 B12 缺乏症很少见。对于两种疾病,缺铁均与低蛋白血症有关。CD 患者的铁和锌缺乏症比 UC 患者更为常见。

结论

铁、锌和维生素 D 缺乏症在儿科 IBD 诊断时很常见,随访期间改善有限,而镁和维生素 B12 缺乏症很少见。

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