52. ESPGHAN, Glasgow, İngiltere, 5 - 08 Haziran 2019, cilt.68, sa.1, ss.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.