P237 Hair mineral and trace element contents as reliable markers of nutritional status compared to serum levels in children with inflammatory bowel disease
Yang H.R.*1,2, Cho J.M.1
1Seoul National University Bundang Hospital, Department of Pediatrics, Seongnam, South Korea 2Seoul National University, Department of Pediatrics, Seoul, South Korea
Patients with inflammatory bowel disease (IBD) are at high risk for mineral and trace element deficiencies because of long-term inflammation in the gut and decreased oral intake. Because serum levels of several micronutrients are influenced by systemic inflammatory responses, serum levels are limited in reflecting body nutrient status in IBD. The aim of this study was to investigate the influence of inflammation on serum micronutrient levels in children, and to evaluate the usefulness of hair mineral and trace element contents as reliable markers for nutritional status compared to serum micronutrient levels in children with IBD.
Between April 2012 and March 2016, a total 86 children (55 boys and 31 girls, aged 4.8–17.4 years) were included and divided into the 3 study groups; Crohn's disease (n=43), ulcerative colitis (n=14), and abdominal pain-related functional gastrointestinal disorder (n=29). Serum mineral and trace element levels, serum prealbumin and albumin levels, hemoglobin and hematocrits, inflammatory markers such as white blood cell counts, lymphocyte counts, C-reactive protein, and erythrocyte sedimentation rate (ESR), and hair mineral and trace element contents were measured in all subjects at initial diagnosis. Statistical analysis was performed among the 3 groups using one-way analysis of variance, and analysis of covariance was used to evaluate inflammation affecting serum micronutrient measurement.
Serum calcium (p<0.001), iron (p<0.001), selenium (p=0.01), prealbumin (p<0.001), albumin (p<0.001), hematocrit (p<0.001), and lymphocyte (p<0.001) were significantly different among the 3 groups. After adjusted for ESR, serum calcium (p=0.012), iron (p<0.001), prealbumin (p<0.001), albumin (p=0.007), hematocrit (p=0.002), and lymphocyte (p=0.008) were still significantly different, whereas serum selenium was not. Regarding hair mineral and trace element analysis, only hair calcium (p=0.04) and selenium contents (p=0.035) were significantly different among the 3 groups, whereas hair iron (p=0.067), zinc (p=0.052), magnesium (p=0.077), copper (p=0.193), manganese (p=0.213), and chromium contents (p=0.687) were not different.
Serum micronutrient levels should be cautiously interpreted in conjunction with inflammatory markers in patients with IBD. Furthermore, hair trace elements measurements may support understanding of body micronutrient status in children with IBD.