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P257 Assessment of the nutritional status of pediatric Inflammatory Bowel Disease patients according to disease activity.

Palomino Pérez, L.M.(1);Velasco Rodríguez-Belvis , M.(1);Cañedo Villaroya, E.(1);Vazquez Gómez, J.A.(1);Muñoz Codoceo, R.A.(1);

(1)Hospital Infantil Universitario Niño Jesús, Paediatric Gastroenterology and Nutrition, Madrid, Spain

Background

To determine the nutritional status in patients with inflammatory bowel disease (IBD) and its possible relationship with the activity of the disease. 

Methods

A cross-sectional and descriptive study of paediatric patients with previously diagnosed or suspected IBD who underwent upper endoscopy (EGD) and colonoscopy, blood tests, stool analysis and MR Enterography (MRE), from October 2018 to February 2020.

Results

We recruited 21 patients and 12 of them were males (57%). A total of 12 patients had Crohn ́s disease (CD) (57%), 3 had ulcerative colitis (UC) (14%), 6 had IBD unclassified (IBDu) (28%). The age at the time of the evaluation was 14.2 ± 0.7 years and the progression time of the disease was 3.9 ± 0.6 years. A total of 16 patients showed clinical remission (76%), and 6 of them (28%) also had endoscopic and histological remission. Eight patients were receiving biological treatment (38%). 

Rotavirus, adenovirus, Clostridium difficile toxin analysis and stool culture were performed in 14 patients, all of them were negative. The weight was 55.7 ± 20.71 kg, the size was 159.1 ± 15.0 cm and the BMI was 21.5 ± 5.6. A total of 7 patients (58%) had malnutrition, 3 (14%) were overweight and 2 (10%) were obese. We found no significant differences in BMI according to the underlying diagnose. 

The results of the blood analysis with nutritional profile were: folic acid 12.3 ± 7.2 ng/ml, vitamin B12 455.2 ± 200.6 pg/ml, ferritin 36.9 ± 16.7 ng/ml, total protein 7.6 ± 0.5 g/dl, albumin 4.4 ± 0.4, prealbumin 22.7 ± 7.0 mg/dl, retinol binding protein 2.2 ± 1.0 mg/dl, vitamin A 0.3 ± 0.1 mg/L, effective vitamin E 4.6 ± 0.7 mg/g, 25(OH) vitamin D 20.1 ± 6.2 ng/ml, vitamin B1 6.1 ± 1.2 mcg/dL, vitamin B6 28.3 ± 9.8 ug/L, IFG-1 312.1 ± 124.1 ng/ml, IGFBP-3 4.4 ± 0.6 μg/ml, PTH 54.9 ± 2.7, Selenium 88.7 ± 23.1, Zinc 99.4 ± 9.3, copper 96.0 ± 11.5 ug/dL. 

We found a significant negative correlation between the IGF-1 levels and the SES-CD values, and between prealbumin levels and Mayo score values (p < 0.05). However, no significant correlations were found between other nutritional values and endoscopic scores. We found a significant negative correlation between the BMI values and the shPCDAI (p < 0.05), but no significant correlation was found with PUCAI. No differences in analytical markers or BMI were found between patients receiving biological treatment and those who were not. 

Conclusion

More than half of the teenager patients with IBD showed some kind of nutritional disturbance. The analytical nutritional markers which related more closely to the endoscopic activity were IGF-1 and prealbumin. The alteration of the clinical score was related to alterations in the BMI in CD but not in the UC patients.

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