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Nutrition in acute and chronic diseases

Nutritional characteristic of children with inflammatory bowel disease in the nationwide inflammatory bowel disease registry from the Mediterranean region

European Journal of Clinical Nutrition volume 76, pages 1289–1296 (2022)Cite this article

Subjects

Abstract

Background/objectives

We analyzed the nationwide pediatric inflammatory bowel disease (PIBD) registry (1998–2016), to evaluate the nutritional status at the time of diagnosis.

Subjects/methods

Nine types of nutritional status by the combination of weight-for-length (<2 years)/body mass index (>2 years) and length/height-for-age with three categories (<−2, −2 to 2, and >2 SD) were described. Malnutrition was defined by WHO criteria. Univariate and multivariate regression analysis was used to identify risk factors for malnutrition.

Results

In total, 824 IBD patients (498 Ulcerative colitis (UC); 289 Crohn’s Disease (CD); 37 Indeterminate Colitis (IC); 412 male; the median age 12.5 years) were eligible. The prevalence of eutrophy, wasting/thinness, stunting, overweight, tall stature, concurrent wasting/thinness and stunting, tall stature with overweight, tall stature with wasting/thinness, and short stature with overweight were 67.4%, 14.9%, 6.6%, 3.1%, 3.2%, 3.3%, 1.1%, 0.4%, and 0.1%, respectively. The prevalence of malnutrition was 32.7%, indicating a higher prevalence in CD (p < 0.001). Incidence of overweight was less common in the CD than UC and IC (p < 0.001). Multivariate analysis revealed that age of onset (>10 years), prepubertal stage, severe disease activity, perianal involvement, and high C reactive protein level were independently associated with malnutrition in pediatric IBD.

Conclusion

We showed the frequency of nutritional impairment in PIBD. The percentage of overweight subjects was lower than the other studies. The age of onset, disease activity, CRP level, perianal involvement, and pubertal stage were associated with a higher risk for developing malnutrition. Our results also confirmed that CD patients are particularly vulnerable to nutritional impairment.

Clinical trial number

ClinicalTrials.gov Identifier: NCT04457518.

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Fig. 1: The patient selection process and the number of participants included.
Fig. 2: Difference in nutritional status of IBD patients at the time of diagnosis according to disease phenotype.

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Data availability

Raw data the support the findings of this study are available from the corresponding author upon reasonable request. The data that support the findings of this study are available in clinicalTrials.gov at https://clinicaltrials.gov/ct2/show/NCT04457518.

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Acknowledgements

We thank all our patients and their families for consenting to this study. A sincere thank to James Denison for editing and reviewing this manuscript for English language.

Funding

This research was funded by The Society of Turkish Pediatric Gastroenterology, Hepatology, and Nutrition.

Author information

Authors and Affiliations

  1. School of Medicine, Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, Ankara University, Ankara, Turkey

    Zarife Kuloglu & Aydan Kansu

  2. Faculty of Medicine, Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, Ege University, İzmir, Turkey

    Funda Çetin

  3. Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, Şişli Hamidiye Etfal Training and Research Hospital, İstanbul, Turkey

    Nafiye Urgancı

  4. Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, Bakırköy Dr. Sadi Konuk Research and Training Center, İstanbul, Turkey

    Zerrin Önal & Günsel Kutluk

  5. Faculty of Medicine, Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, Gazi University University, Ankara, Turkey

    Sinan Sarı & Buket Dalgıç

  6. Meram Faculty of Medicine, Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, Necmettin Erbakan University, Konya, Turkey

    Hasan Yüksekkaya & Aylin Yücel

  7. Faculty of Medicine, Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, Ondokuz Mayıs University, Samsun, Turkey

    Gönül Çaltepe & Ayhan Gazi Kalaycı

  8. School of Medicine, Department of Biostatistics, Ankara University , Ankara, Turkey

    Ebru Dumlupinar

  9. School of Medicine, Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, Süleyman Demirel University, Isparta, Turkey

    Mustafa Akçam

  10. Faculty of Medicine, Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, Erciyes University, Kayseri, Turkey

    Duran Arslan

  11. Faculty of Medicine, Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, Dokuz Eylül University, İzmir, Turkey

    Nur Arslan & Yeşim Öztürk

  12. Faculty of Medicine, Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, Akdeniz University, Antalya, Turkey

    Reha Artan

  13. Faculty of Medicine, Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, Kocaeli University, Kocaeli, Turkey

    Ayşen Uncuoğlu Aydoğan

  14. Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Gülhane Training and Research Hospital, Ankara, Turkey

    Necati Balamtekin

  15. Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Tepecik Training and Research Hospital, Izmir, Turkey

    Maşallah Baran

  16. Faculty of Medicine, Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, Dicle University, Diyarbakır, Turkey

    Gökhan Baysoy

  17. Faculty of Medicine, Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, Karadeniz University, Trabzon, Turkey

    Murat Çakır

  18. Faculty of Medicine, Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, Şifa University, İzmir, Turkey

    Coşkun Çeltik

  19. Faculty of Medicine, Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, Fırat University, Elazığ, Turkey

    Yaşar Doğan

  20. Istanbul Faculty of Medicine, Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, İstanbul University, Istanbul, Turkey

    Özlem Durmaz

  21. Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Behcet Uz Training and Research Hospital, Izmir, Turkey

    Çiğdem Ecevit & Özlem Bekem Soylu

  22. Faculty of Medicine, Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, Osmangazi University, Eskişehir, Turkey

    Makbule Eren

  23. Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Erzurum Region Training and Research Hospital, Erzurum, Turkey

    Gülin Erdemir

  24. Faculty of Medicine, Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, Bezmialem University, Istanbul, Turkey

    Selim Gökçe

  25. Faculty of Medicine, Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, Kırıkkale University, Kırıkale, Turkey

    Fulya Gulerman

  26. Division of Pediatric Gastroenterology, Hepatology, and Nutrition, American Hospital, Istanbul, Turkey

    Figen Gürakan

  27. Faculty of Medicine, Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, Gaziantep University, Gaziantep, Turkey

    Şamil Hızlı

  28. Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Dr. Sami Ulus Children’s Hospital, Ankara, Turkey

    Ferda Özbay Hoşnut

  29. Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Kayseri Training and Research Hospital, Kayseri, Turkey

    İshak Işık

  30. Faculty of Medicine, Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, İnönü University, Malatya, Turkey

    Hamza Karabiber

  31. Faculty of Medicine, Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, Celal Bayar, Manisa, Turkey

    Erhun Kasırga

  32. Faculty of Medicine, Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, Hacettepe University, Ankara, Turkey

    Hasan Özen

  33. Faculty of Medicine, Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, Uludag University, Bursa, Turkey

    Tanju Özkan

  34. Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Konya Training and Research Hospital, Konya, Turkey

    Ersin Sayar

  35. Faculty of Medicine, Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, Atatürk University, Erzurum, Turkey

    Mahya Sultan Tosun

  36. Faculty of Medicine, Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, Cukurova University, Adana, Turkey

    Gökhan Tümgör

  37. Faculty of Medicine, Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, Yeditepe University, Istanbul, Turkey

    Meltem Korkut Uğraş

  38. Private Practise, Bursa, Turkey

    Fatih Ünal

  39. Faculty of Medicine, Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, Bulent Ecevit University, Zonguldak, Turkey

    Gonca Handan Üstündağ

  40. Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Turkish Republic Health Ministry, Ankara Child Health Diseases, Haematology Oncology Training and Research Hospital, Ankara, Turkey

    Aytaç Yaman

Authors
  1. Zarife Kuloglu
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  2. Funda Çetin
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  3. Nafiye Urgancı
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  4. Zerrin Önal
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  5. Sinan Sarı
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  6. Hasan Yüksekkaya
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  7. Gönül Çaltepe
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  8. Günsel Kutluk
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  9. Ebru Dumlupinar
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Consortia

Turkish Inflammatory Bowel Disease Study Group

  • Mustafa Akçam
  • , Duran Arslan
  • , Nur Arslan
  • , Reha Artan
  • , Ayşen Uncuoğlu Aydoğan
  • , Necati Balamtekin
  • , Maşallah Baran
  • , Gökhan Baysoy
  • , Murat Çakır
  • , Coşkun Çeltik
  • , Buket Dalgıç
  • , Yaşar Doğan
  • , Özlem Durmaz
  • , Çiğdem Ecevit
  • , Makbule Eren
  • , Gülin Erdemir
  • , Selim Gökçe
  • , Fulya Gulerman
  • , Figen Gürakan
  • , Şamil Hızlı
  • , Ferda Özbay Hoşnut
  • , İshak Işık
  • , Ayhan Gazi Kalaycı
  • , Aydan Kansu
  • , Hamza Karabiber
  • , Erhun Kasırga
  • , Hasan Özen
  • , Tanju Özkan
  • , Yeşim Öztürk
  • , Ersin Sayar
  • , Özlem Bekem Soylu
  • , Mahya Sultan Tosun
  • , Gökhan Tümgör
  • , Meltem Korkut Uğraş
  • , Fatih Ünal
  • , Gonca Handan Üstündağ
  • , Aytaç Yaman
  •  & Aylin Yücel

Contributions

All authors were provided data input as a part of a project of Nationwide Registry for Pediatric Inflammatory Bowel Disease (NRPIBD). The specific contribution of each author is listed below: Kuloglu Z was responsible for the study concept and design, analysis, intrepretation of data and drafting of the manuscript. Çetin F was the project manager for the project of NRPIBD. Kansu A was responsible for critical review of manuscript. ED was responsible for the statistic analysis. All authors approved the final version of the manuscript.

Corresponding author

Correspondence to Zarife Kuloglu.

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Competing interests

The authors declare no competing interests.

Ethical approval

The study protocol was approved by Ege University Ethics Committee (October 12, 2011, No: 11-7/2).

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Kuloglu, Z., Çetin, F., Urgancı, N. et al. Nutritional characteristic of children with inflammatory bowel disease in the nationwide inflammatory bowel disease registry from the Mediterranean region. Eur J Clin Nutr 76, 1289–1296 (2022). https://doi.org/10.1038/s41430-022-01094-6

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