Basic anthropometry, micronutrients status and growth velocity of patients with early-onset inflammatory bowel disease: A prospective cohort study

Nehal M El Koofy; Eman Mohamed Ibraheim Moawad; Noha A Yassin; Mohammad N Almohammady; Gehan S Ibrahim; Fatma A El Mougy; Ahmed A El Ayadi; Sara Tarek

doi:10.1016/j.ajg.2022.06.004

Basic anthropometry, micronutrients status and growth velocity of patients with early-onset inflammatory bowel disease: A prospective cohort study

Arab J Gastroenterol. 2022 Nov;23(4):270-276. doi: 10.1016/j.ajg.2022.06.004. Epub 2022 Jul 30.

Authors

Nehal M El Koofy¹, Eman Mohamed Ibraheim Moawad¹, Noha A Yassin¹, Mohammad N Almohammady¹, Gehan S Ibrahim¹, Fatma A El Mougy², Ahmed A El Ayadi¹, Sara Tarek³

Affiliations

¹ Pediatric Department, Faculty of Medicine Cairo University, Cairo, Egypt.
² Clinical and Chemical Pathology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
³ Pediatric Department, Faculty of Medicine Cairo University, Cairo, Egypt. Electronic address: sara.tarek2310@outlook.com.

PMID: 35918289
DOI: 10.1016/j.ajg.2022.06.004

Abstract

Background and study aim: Failure of optimal growth and lack of appropriate weight gain are major nutritional problems in children with inflammatory bowel disease (IBD). Therefore, this study was designed to assess the nutritional and growth status of patients with very-early-onset IBD (VEO-IBD) before and after individual-based nutritional interventions.

Patients and methods: This prospective cohort study assessed the nutritional status of 30 pediatric patients with VEO-IBD by performing comprehensive clinical examinations and evaluating anthropometric and biochemical parameters. The latter included the initial evaluation of serum albumin, prealbumin, minerals, and 25-hydroxyvitamin D. A 24-month nutritional strategy was designed for each patient. Patients who completed the study were reassessed after 6 months and their growth rate was calculated 2 years later.

Results: The initial assessment of malnutrition severity using the World Health Organization's z-score revealed that 36.7%, 43.3%, and 26.7% of the study group were underweight, stunted, and wasted, respectively. Among the study population, Crohn's disease has the highest prevalence. Almost all patients had micronutrient deficiencies (i.e., iron, calcium, zinc, magnesium, and vitamin D) and subnormal serum levels of nutritional markers (i.e., prealbumin and albumin). Six months after the intervention, a significant improvement in anthropometric and biochemical parameters was detected (p < 0.05); nevertheless, the calculated growth rate revealed a considerable decrease after 2 years.

Conclusion: The early detection of nutritional impairment in patients with VEO-IBD remains a major challenge. Therefore, nutritional support and constant monitoring of these patients are necessary to ensure the improvement in their nutritional status and achieve an acceptable growth rate. Furthermore, we found that prealbumin could be a good discriminative tool for screening malnutrition in such patients.

Keywords: IOIBD; Nutritional assessment; Nutritional support; VEO-IBD.

MeSH terms

Child
Humans
Inflammatory Bowel Diseases* / complications
Inflammatory Bowel Diseases* / diagnosis
Micronutrients*
Prospective Studies

Substances

Micronutrients