Nutritional Status and Growth in Korean Children with Crohn’s Disease: A Single-Center Study
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Background/Aims: Malnutrition and growth retardation areimportant issues in treating pediatric Crohn’s disease (CD). Thus, we aimed to investigate the prevalence of variousnutritional and growth parameters at the time of diagnosisin Korean children with CD. Methods: Seventy-one children(<18 years) were enrolled. We analyzed the Z-scores ofheight-for-age (HAZ), weight-for-height (WHZ), body massindex for age (BMIZ), bone mineral density for age (BMDZ),and the biochemical markers measured at the time of diagnosis. Results: At diagnosis, HAZ <-2 was observed in threepatients (4%), WHZ <-2 in 20 patients (28%), BMIZ <-2 in19 patients (27%), and BMDZ <-2 in 11 patients (18%). TheHAZ was significantly lower in females and patients withextraintestinal manifestations, and the WHZ and BMIZ weresignificantly lower in patients with stricturing and penetratingdisease. Subnormal serum levels were highly prevalent forhemoglobin, albumin, iron, ferritin, calcium, magnesium, folate,vitamin B12, and zinc. There was a significant correlationbetween nutritional status, growth retardation, and diseaseactivity. Conclusions: Abnormal nutritional status was highlyprevalent in Korean children with CD at the time of diagnosisand was associated with the extent, behavior, and activity ofthe disease.
Abstract
Background/Aims: Malnutrition and growth retardation areimportant issues in treating pediatric Crohn’s disease (CD). Thus, we aimed to investigate the prevalence of variousnutritional and growth parameters at the time of diagnosisin Korean children with CD. Methods: Seventy-one children(<18 years) were enrolled. We analyzed the Z-scores ofheight-for-age (HAZ), weight-for-height (WHZ), body massindex for age (BMIZ), bone mineral density for age (BMDZ),and the biochemical markers measured at the time of diagnosis. Results: At diagnosis, HAZ <-2 was observed in threepatients (4%), WHZ <-2 in 20 patients (28%), BMIZ <-2 in19 patients (27%), and BMDZ <-2 in 11 patients (18%). TheHAZ was significantly lower in females and patients withextraintestinal manifestations, and the WHZ and BMIZ weresignificantly lower in patients with stricturing and penetratingdisease. Subnormal serum levels were highly prevalent forhemoglobin, albumin, iron, ferritin, calcium, magnesium, folate,vitamin B12, and zinc. There was a significant correlationbetween nutritional status, growth retardation, and diseaseactivity. Conclusions: Abnormal nutritional status was highlyprevalent in Korean children with CD at the time of diagnosisand was associated with the extent, behavior, and activity ofthe disease.
참고문헌 (32)
- Leong RW, "The epidemiology and phenotype of Crohn’s disease in the Chinese population", Inflamm Bowel Dis, 10, pp.646~651 (2004)
- Thia KT, "An update on the epidemiology of inflammatory bowel disease in Asia", Am J Gastroenterol, 103, pp.3167~3182 (2008)
- Yang SK, "Epidemiology of inflammatory bowel disease in the Songpa-Kangdong district, Seoul, Korea, 1986-2005: a KASID study", Inflamm Bowel Dis, 14, pp.542~549 (2008)
- Kim BJ, "Characteristics and trends in the incidence of inflammatory bowel disease in Korean children: a single-center experience", Dig Dis Sci, 55, pp.1989~1995 (2010)
- Motil KJ, "Growth failure in children with inflammatory bowel disease: a prospective study", Gastroenterology, 105, pp.681~691 (1993)
- Markowitz J, "Growth failure in pediatric inflammatory bowel disease", J Pediatr Gastroenterol Nutr, 16, pp.373~380 (1993)
- Dieleman LA, "Nutritional issues in inflammatory bowel disease", Gastroenterol Clin North Am, 27, pp.435~451 (1998)
- Heuschkel R, "Guidelines for the management of growth failure in childhood inflammatory bowel disease", Inflamm Bowel Dis, 14, pp.839~849 (2008)
- Escher JC, "Inflammatory bowel disease in children and adolescents: recommendations for diagnosis: the Porto criteria", J Pediatr Gastroenterol Nutr, 41, pp.1~7 (2005)
- Bousvaros A, "Differentiating ulcerative colitis from Crohn disease in children and young adults: report of a working group of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition and the Crohn’s and Colitis Foundation of America", J Pediatr Gastroenterol Nutr, 44, pp.653~674 (2007)
- Maconi G, "Transperineal ultrasound in the detection of perianal and rectovaginal fistulae in Crohn’s disease", Am J Gastroenterol, 102, pp.2214~2219 (2007)
- Levine A, "Pediatric modification of the Montreal classification for inflammatory bowel disease: the Paris classification", Inflamm Bowel Dis, 17, pp.1314~1321 (2011)
- Hyams JS, "Development and validation of a pediatric Crohn’s disease activity index", J Pediatr Gastroenterol Nutr, 12, pp.439~447 (1991)
- Hyams J, "Evaluation of the pediatric Crohn disease activity index: a prospective multicenter experience", J Pediatr Gastroenterol Nutr, 41, pp.416~421 (2005)
- Joosten KF, "Malnutrition in pediatric hospital patients: current issues", Nutrition, 27, pp.133~137 (2011)
- Aiges H, "Home nocturnal supplemental nasogastric feedings in growth-retarded adolescents with Crohn’s disease", Gastroenterology, 97, pp.905~910 (1989)
- 문진수, "2007 한국 소아 청소년 성장도표 : 개발 과정과 전망", Korean Journal of Pediatrics, 51(1), pp.1~25 (2008), 대한소아과학회
- Spray C, "Current diagnosis, management and morbidity in paediatric inflammatory bowel disease", Acta Paediatr, 90, pp.400~405 (2001)
- Seo JK, "Inflammatory bowel disease in children: clinical, endoscopic, radiologic and histopathologic investigation", J Korean Med Sci, 7, pp.221~235 (1992)
- Sawczenko A, "Presenting features of inflammatory bowel disease in Great Britain and Ireland", Arch Dis Child, 88, pp.995~1000 (2003)
- Gasche C, "Guidelines on the diagnosis and management of iron deficiency and anemia in inflammatory bowel diseases", Inflamm Bowel Dis, 13, pp.1545~1553 (2007)
- Semrin G, "Impaired intestinal iron absorption in Crohn’s disease correlates with disease activity and markers of inflammation", Inflamm Bowel Dis, 12, pp.1101~1106 (2006)
- Wilson A, "Prevalence and outcomes of anemia in inflammatory bowel disease: a systematic review of the literature", Am J Med, 116(Suppl 7A), pp.44S~49S (2004)
- Burbige EJ, "Clinical manifestations of Crohn’s disease in children and adolescents", Pediatrics, 55, pp.866~871 (1975)
- Shamir R, "Growth retardation in pediatric Crohn’s disease: pathogenesis and interventions", Inflamm Bowel Dis, 13, pp.620~628 (2007)
- Galland L, "Magnesium and inflammatory bowel disease", Magnesium, 7, pp.78~83 (1988)
- Sawczenko A, "Intestinal inflammation-induced growth retardation acts through IL-6 in rats and depends on the -174 IL-6 G", C polymorphism in children, 2005, pp.102, 13260~13265
- Kanof ME, "Decreased height velocity in children and adolescents before the diagnosis of Crohn’s disease", Gastroenterology, 95, pp.1523~1527 (1988)
- Corkins MR, "The insulin-like growth factor axis in children with inflammatory bowel disease", J Pediatr Gastroenterol Nutr, 36, pp.228~234 (2003)
- Ladner KJ, "Tumor necrosis factor-regulated biphasic activation of NF-kappa B is required for cytokine-induced loss of skeletal muscle gene products", J Biol Chem, 278, pp.2294~2303 (2003)
- Sawczenko A, "Clinical features affecting final adult height in patients with pediatric-onset Crohn’s disease", Pediatrics, 118, pp.124~129 (2006)
- Tanner JM, "Clinical longitudinal standards for height and height velocity for North American children", J Pediatr, 107, pp.317~329 (1985)