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[Assessment of serum micronutrients in children with short bowel syndrome]
Yi Feng1, Wei Cai, Qing-ya Tang
1Clinical Nutrition Center, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200092, China.
Insights
Micronutrient deficiencies are common in children with short bowel syndrome. Supplementation is crucial for these patients, regardless of their diet or need for parenteral nutrition (PN).
Area of Science:
- Pediatric Gastroenterology
- Nutritional Science
- Clinical Chemistry
Context:
- Short bowel syndrome (SBS) presents significant challenges in nutrient absorption.
- Assessing micronutrient status is vital for managing SBS patients.
- Parenteral nutrition (PN) and intestinal length impact nutritional outcomes.
Purpose:
- To evaluate the levels of key micronutrients (vitamins A, E, beta-carotene, iron, zinc, copper) in children diagnosed with short bowel syndrome.
- To identify potential correlations between micronutrient deficiencies and clinical factors such as reliance on PN, remaining intestinal length, and ileocecal valve status.
Summary:
- A study of 17 children with SBS revealed high incidences of low vitamin A (23.5%), vitamin E (35.3%), and beta-carotene (58.8%).
- Deficiencies were more prevalent in patients with less remaining intestine (<75 cm), without an ileocecal valve, or weaned from PN.
- Lower serum zinc and iron levels were also observed in a subset of patients.
Impact:
- Highlights the essential need for micronutrient supplementation in pediatric SBS patients.
- Emphasizes the importance of regular monitoring and tailored nutritional support for improved patient outcomes.
- Informs clinical practice regarding proactive micronutrient management in SBS.
Objective:
To assess micronutrients level in children with short bowel syndrome.
Methods:
Clinical data of 17 children with short bowel syndrome from April 2004 to July 2006 were collected. They received the measurement of serum vitamin A, E and - carotene by high performance liquid chromatography (HPLC).
Results:
There were 9 boys and 8 girls with age range of 3 months to 18 years. Eleven children did not need parenteral nutrition (PN), and 6 still depended on PN. Six cases were free of ileocolic valve and 11 cases had ileocolic valve. The length of remaining intestine was more than 75 cm in 5 patients and less than 75 cm in 12 patients. Among 11 cases without PN, 9 were tested for serum iron, zinc and copper levels. Their incidences of below the reference value of vitamin A, E and beta - carotene were 23.5%, 35.3% and 58.8%, respectively. The incidences of below the reference value of vitamin A and beta - carotene were higher in patients with weaned PN, less than 75 cm remaining intestine and without ileocolic valve. The patients with more than 75 cm remaining intestine and still with PN had a higher incidence of below the reference of vitamin E, but the incidence was similar in the patients with or without ileocolic valve. Serum zinc was lower than normal level in 3 cases and serum iron was low in 1 case.
Conclusion:
Supplement of extra micronutrients is essential for short bowl syndrome patient whatever they receive the PN or have normal diets, and follow- up is recommended.
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