Nutritional status and growth in Korean children with Crohn's disease: a single-center study

Abstract

Background/aims: Malnutrition and growth retardation are important issues in treating pediatric Crohn's disease (CD). Thus, we aimed to investigate the prevalence of various nutritional and growth parameters at the time of diagnosis in Korean children with CD.

Methods: Seventy-one children (<18 years) were enrolled. We analyzed the Z-scores of height-for-age (HAZ), weight-for-height (WHZ), body mass index 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 three patients (4%), WHZ <-2 in 20 patients (28%), BMIZ <-2 in 19 patients (27%), and BMDZ <-2 in 11 patients (18%). The HAZ was significantly lower in females and patients with extraintestinal manifestations, and the WHZ and BMIZ were significantly lower in patients with stricturing and penetrating disease. Subnormal serum levels were highly prevalent for hemoglobin, albumin, iron, ferritin, calcium, magnesium, folate, vitamin B12, and zinc. There was a significant correlation between nutritional status, growth retardation, and disease activity.

Conclusions: Abnormal nutritional status was highly prevalent in Korean children with CD at the time of diagnosis and was associated with the extent, behavior, and activity of the disease.

Keywords: Bone density; Crohn’s disease; Growth disorder; Malnutrition; Pediatrics.

Fig. 1

Annual number of newly diagnosed pediatric Crohn’s disease (CD) patients at Asan Medical Center between 1996 and 2010. Starting in 2000, we noted that the number of children with CD rapidly increased.

Fig. 2

Distribution and mean of Z-scores for height-for-age (A), weight-for-height (B), body mass index (BMI) (C), and bone mineral density (BMD) (D) in patients with Crohn’s disease at the time of diagnosis and percentages (in black) of children with values less than −2 standard deviation.