Department of Pediatrics and Child Health, Kurume University School of Medicine, 67 Asahi-machi, Kurume, 8300011, Japan.
Division of Gastroenterology, National Center for Child Health and Development, Tokyo, Japan.
Dig Dis Sci. 2022 Jun;67(6):2485-2491. doi: 10.1007/s10620-021-07078-z. Epub 2021 Jun 8.
Reports of zinc and selenium deficiencies accompanying inflammatory bowel disease (IBD) mostly have originated from Western countries and concerned adult patients. Whether Japanese children with IBD have similar deficiencies remained unclear.
We aimed to elucidate differences in serum zinc and selenium concentrations in Japanese children between types of IBD.
Children under 17 years old undergoing care at 12 Japanese pediatric centers were retrospectively enrolled between November 2016 and February 2018 to 3 groups representing Crohn's disease (CD), ulcerative colitis (UC), and normal controls (NC) with irritable bowel syndrome or no illnesses. Serum zinc and selenium were measured by atomic absorption spectrophotometry. Zinc and selenium deficiencies were defined by serum concentrations < 70 μg/dL and < 9.5 μg/dL, respectively.
Subjects included 98 patients with CD (median age, 13 years), 118 with UC (11 years), and 43 NC (11 years). Serum zinc and selenium were significantly lower in CD (median, 64 and 12.6 μg/dL respectively) than in UC (69 and 14.6; P < 0.05 and P < 0.001) or NC (77 and 15.7; P < 0.01 and P < 0.001). Zinc deficiency was significantly more prevalent in CD (60.2%) than in NC (37.2%; P < 0.05), but not than in UC (51.7%; P = 0.22). Selenium deficiency was significantly more prevalent in CD (15.3%) than in UC (5.9%; P < 0.05) or NC (0%; P < 0.01).
In Japanese children under 17 years old, serum zinc and selenium were significantly lower in CD than in UC or NC. Zinc and selenium should be monitored, and supplemented when deficient, in children with IBD, especially CD.
伴随炎症性肠病(IBD)的锌和硒缺乏的报告主要来自西方国家,且涉及成年患者。日本儿童 IBD 是否存在类似的缺乏情况尚不清楚。
我们旨在阐明日本儿童 IBD 各类型间血清锌和硒浓度的差异。
2016 年 11 月至 2018 年 2 月,12 家日本儿科中心回顾性招募了 17 岁以下正在接受治疗的儿童,分为克罗恩病(CD)、溃疡性结肠炎(UC)和正常对照组(NC)(伴有肠易激综合征或无疾病)3 组。通过原子吸收分光光度法测量血清锌和硒。血清锌和硒缺乏分别定义为血清浓度 < 70μg/dL 和 < 9.5μg/dL。
纳入 98 例 CD(中位年龄 13 岁)、118 例 UC(11 岁)和 43 例 NC(11 岁)患者。与 UC(69μg/dL 和 14.6μg/dL)或 NC(67μg/dL 和 15.7μg/dL)相比,CD 患者的血清锌和硒明显更低(中位数分别为 64μg/dL 和 12.6μg/dL;P < 0.05 和 P < 0.001)。与 NC(37.2%)相比,CD 患者锌缺乏的发生率显著更高(60.2%;P < 0.05),但与 UC(51.7%)相比无显著差异(P = 0.22)。与 UC(5.9%)或 NC(0%)相比,CD 患者硒缺乏的发生率显著更高(15.3%;P < 0.05)。
在 17 岁以下的日本儿童中,与 UC 或 NC 相比,CD 患者的血清锌和硒明显更低。应监测 IBD 患儿,尤其是 CD 患儿的锌和硒水平,必要时应补充。