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©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
Nutritional status of children with inflammatory bowel disease in Saudi Arabia
Mohammad Issa El Mouzan, Mohammed Hadi Al Edreesi, Abdulrahman Abdullah Al-Hussaini, Omar Ibrahim Saadah, Abdulaziz Abdullatif Al Qourain, Mohammad Abdullah Al Mofarreh, Khalid Abdulrahman Al Saleem
Mohammad Issa El Mouzan, Department of Pediatrics, Head, Pediatric IBD Research Group, Member of Prince Abdullah Bin Khalid Celiac Disease Research Chair, King Saud University, Riyadh 11461, Saudi Arabia
Mohammed Hadi Al Edreesi, Department of Pediatrics, Saudi Aramco Medical Services Organization Dhahran Health Center, Dhahran 31311, Saudi Arabia
Abdulrahman Abdullah Al-Hussaini, Division of Gastroenterology, Hepatology, King Saud Bin Abdul Aziz University for Health Sciences, The Children’s Hospital, King Fahad Medical City, Riyadh 11525, Saudi Arabia
Omar Ibrahim Saadah, Department of Pediatrics, Faculty of Medicine & Inflammatory Bowel Disease Research Group, King Abdul Aziz University, Jeddah 21589, Saudi Arabia
Abdulaziz Abdullatif Al Qourain, Department of Medicine, Division of Gastroenterology, King Fahad Hospital of the University, Dammam University, Dammam 31952, Saudi Arabia
Mohammad Abdullah Al Mofarreh, Department of Gastroenterology, Mofarreh Poly Clinic, Riyadh 11423, Saudi Arabia
Khalid Abdulrahman Al Saleem, Section of Pediatric Gastroenterology, Department of Pediatrics, King Faisal Specialist Hospital & Research Centre, Riyadh 11525, Saudi Arabia
Author contributions: El Mouzan MI designed the study, supervised the data collection and drafted the article; Al Edreesi MH, Saadah OI, Al Qourain AA, Al Mofarreh MA and Al Saleem KA supervised the data collection in their each center and critically reviewed the manuscript; Al-Hussaini AA participated in the data collection and critically reviewed the manuscript.
Supported by The Deanship of Scientific Research at King Saud University through Research Group, No. RG-1436-007.
Institutional review board statement: This report constitutes a portion of the national study of the characteristics of IBD in Saudi children, approved by the Institutional Review Board, College of Medicine, King Saud University (No. 10/2647/IRB).
Conflict-of-interest statement: The authors declare no conflicts of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Mohammad Issa El Mouzan, MD, Department of Pediatrics, Head, Pediatric IBD Research Group, Member of Prince Abdullah Bin Khalid Celiac Disease Research Chair, King Saud University, PO Box 2925, Riyadh 11461, Saudi Arabia.
drmouzan@gmail.com
Telephone: +966-11-4670807 Fax: +966-11-4679463
Received: June 25, 2015
Peer-review started: June 27, 2015
First decision: August 26, 2015
Revised: September 13, 2015
Accepted: November 13, 2015
Article in press: November 13, 2015
Published online: February 7, 2016
Processing time: 210 Days and 8.6 Hours
AIM: To assess the prevalence of nutritional disorders in children with inflammatory bowel disease (IBD) in Saudi Arabia.
METHODS: The data from a national cohort of children newly diagnosed with IBD between 2003 and 2012 were analyzed. The diagnosis of IBD and the differentiation between Crohn’s disease (CD) and ulcerative colitis (UC) were confirmed by gastroenterologists according to the standard criteria. The body mass index (BMI) of each child [weight (kg)/height2 (m)] was calculated at the time of diagnosis. The World Health Organization standards and references were used and the BMI for age > +1 and < -2 standard deviation score were used to define overweight and thinness, respectively. Age stratification analysis was performed to investigate any age-related variation in the prevalence of nutritional status between children < 10 years of age and older.
RESULTS: There were 374 children from 0.33 to 17 years of age, including 119 (32%) children with UC and 255 (68%) with CD. All of the children were Saudi nationals, and 68 (57%) of the UC and 150 (59%) of the CD children were males. A positive history of anorexia at the time of diagnosis was found in 30 (25%) patients with UC and 99 (39%) patients with CD. The prevalence of thinness was 31%, 35% and 24% in children with IBD, CD and UC, respectively, with a significantly higher prevalence of thinness in children with CD than in children with UC (P = 0.037) only in the age group of 10-17 years (P = 0.030). The prevalence of overweight was 16 %, 15% and 20 % in the children with IBD, CD and UC, respectively, indicating a higher prevalence in UC that was statistically significant only in the age group of 10-17 years (P = 0.020).
CONCLUSION: A high proportion of children with IBD presented with overweight instead of the classical underweight. Awareness of this finding is important for patient care.
Core tip: This study is the first from a developing country to demonstrate that a high proportion of children with inflammatory bowel disease (IBD) presented with overweight instead of the classical underweight. Age stratification revealed a significant variation between Crohn’s disease and ulcerative colitis in the prevalence of thinness as well as overweight between children < 10 years of age and older children. Physicians caring for children should be aware that children with IBD may present with overweight instead of the classical underweight.
