İnflamatuar Barsak Hastalığı Olan Çocukların Beslenme Durumunun ve Kemik Mineral Yoğunluğunun Değerlendirilmesi

Abstract

This cross-sectional study was planned to determine the relationship among disease severity and duration with nutritional status, anthropometric measures, bone mineral density and biochemical assay. The study was conducted on 45 volunteer pediatric inflammatory bowel disease patients (n=18 ulcerative colitis-UC n=27 Crohn’s disease-CD) at Hacettepe University İhsan Doğramacı Children’s Hospital, Division of Pediatric Gastroeneterology, Hepatology. General characterictics, food consumption and physical activity level were assessed. Body composition analysis via BIA, biochemical assay (25-OH-D3, albumin, CRP etc.) and bone mineral density analysis via DEXA were performed. Disease severity was evaluated by specialists using PCDAI and PUCAI. 11.1% of patients were stunted, 28.9% were short according to height for age Z scores. Height for age Z score were negatively correlated with cumulative corticosteroid dose and positively correlated with physical activity level, calcium and vitamin D intake in percent of daily recommendation (p<0.05). Height for age Z score, BMI for age Z score, fat free mass index (FFMI) and fat mass index (FMI) were not significantly different between Crohn’s disease and ulcerative colitis (p>0.05). FMI wasn’t different among disease severity groups (p>0.05) whereas BMI for age Z score and FFMI were significantly lower in moderate-severe group than both remission and mild group (p<0.05). PCDAI (β=-0.16 CI:-0.28,-0.01 p=0.043) and PUCAI (β=-0.32 CI:-0.21,-0.08 p=0.001) were negatively correlated with FFMI. Energy intake in percent of daily recommendation were moderately and negatively correlated with PUCAI and PCDAI (p<0.05). 17% of participants were vitamin D deficient, %37 were insufficient. 21.9% (n=7) of participants whose DEXA analysis were performed were osteoporotic, 21.9% (n=7) were osteopenic. Body composition analysis is an essential component of assessment of nutritional status in children with inflammatory bowel disease throughout the follow-up.