Published online Feb 7, 2016. doi: 10.3748/wjg.v22.i5.1854
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.