Evaluation of nutritional status, trace element levels and fat malabsorption in children with inflammatory bowel disease

Aim: This study aims to evaluate growth and nutritional status, serum and hair levels of zinc and selenium as trace elements and fat malabsorption status with anthropometric measurements, relevant biochemical findings and clinical features of 2-18 years old children with inflammatory bowel disease (IBD). Material and Methods: This study was conducted on 32 volunteer children with IBD (12 girls, median age 15.3 years, 14 ulcerative colitis, 18 Crohn patients) followed in outpatient clinic of Istanbul University, Istanbul Medical Faculty Department of Pediatric Gastroenterology, Hepatology and Nutrition. General characteristics, disease activity, nutritional status of patients were evaluated with measured anthropometric findings. Zinc and selenium levels in serum and hair along with fecal steatocrit as an indicator of fat malabsorption (steatorrhea) were measured. Routine requested biochemical assays of patients were also evaluated. The relationship between zinc and selenium levels and factors related to the disease was investigated evaluating the data obtained. Results: In the whole, 81.3% of the patients were in remission. As nutritional status, 18.8% acute and 12.5% had chronic malnutrition. Crohn patients' height for age Z score was found significantly lower compared to ulcerative colitis patients' (p<0.05). Serum zinc and selenium levels were low in 31.3% and 6.3% of patients, respectively. Twenty seven children's hair samples could be examined for hair zinc and selenium levels and were found low in 7.4% and 3.7%, respectively. Steatocrit was high in 78.1% of all patients. There was no significant relationship between high steatocrit levels and zinc and also selenium levels (p>0.05). Conclusion: Although children with IBD are thought to be at risk in terms of zinc and selenium deficiencies, serious deficiencies of these trace elements can be prevented by keeping the disease in remission and with proper nutrition. Despite the presence of mild steatorrhea as a malabsorption indicator, this does not affect zinc and selenium levels. Zinc deficiency, which is relatively common in patients, can be identified and replaced if levels are measured during routine follow-ups.