Vitamin deficiencies in children with Inflammatory Bowel Disease.

Ertem Şahinoğlu D. , Volkan B., Akkelle B., Şengül Ö., Tutar E.

52. ESPGHAN, Glasgow, United Kingdom, 5 - 08 June 2019, vol.68, no.1, pp.636

  • Publication Type: Conference Paper / Full Text
  • Volume: 68
  • City: Glasgow
  • Country: United Kingdom
  • Page Numbers: pp.636


 Objectives and Study: Micronutrient and vitamin deficiencies have been reported in patients with

inflammatory bowel disease. However, there are limited data regarding the association between the

disease activity and micronutrients-vitamin deficiencies in pediatric population. The aim of this study

was to describe the association between micronutrient-vitamin deficiencies and the activity of

inflammatory bowel disease at diagnosis in children inflammatory bowel disease

 Methods: The medical records of children with IBD who were diagnosed between 2010 and 2018

were retrieved and analyzed. Anthropometric parameters (z-scores for weight and height for age) and

serum levels of micronutrients-vitamins (vitamin D, folic acid, vitamin B12, ferritin, complete blood

count, erythrocyte sedimentation rate-ESR, C reactive protein-CRP) were retrieved. Disease activity at

diagnosis, assessed by the Paediatric Crohn's Disease Activity Index (PCDAI) or the Paediatric

Ulcerative Colitis Activity Index (PUCAI) were also recorded. The patients with UC and CD were

compared in terms of demographic data, laboratory findings and the disease activity.

 Results: The data of 123 children with IBD (66 UC and 57 CD) were analysed. The demographic

characteristics and laboratory findings of patients with UC and CD were shown in Table 1. There were

no differences in terms of anthropometric parameters, hemoglobin, serum vitamin D and folate levels

between two groups. Of the 29.8% patients with CD and 13.6% patients with UC had vitamin B12

deficiency. The mean serum vitamin B12 level was significantly lower in patients with CD compared to

those with UC. There was no folate deficiency in this cohort. Serum vitamin D level was low in 63.2%

and 42.4% of patients with CD and UC, respectively. In this cohort, 47.4% (27) patients with CD and

57.5% (38) patients with UC had moderate and severe disease activity, according to PCDAI or PUCAI.

The patients with moderate and severe CD had higher serum levels of CRP and ferritin, platelet count,

ESR than those with moderate and severe UC (48.5±34 mg/L vs 13.4±18.3 mg/L, 85.5±79 ng/mL vs.

14.5±19.2 ng/mL, 561x103±204x103 μl vs 418x103±121x103 μl , 60.8±25.3 mm/hr vs. 35.7±25.2 mm/hr,

respectively) (p= 0.001). However, there were no significant correlation between serum vitamin levels

and inflammation markers in patients with CD and UC.

 Conclusion: At diagnosis, the rate of vitamin B12 and vitamin D deficiencies are high in patients with

CD and UC, and the mean serum level of these vitamins are lower in patients with CD than those with

UC. But higher inflammation markers were not associated with lower vitamin levels. The children with

IBD are at a higher risk for micronutrient deficiencies, regardless of their disease activity.