Zinc status in adolescents with Crohn's disease

Abstract

It is generally agreed that nutrient deficiencies and growth failure are common complications of adolescents with inflammatory bowel disease (IBD). Many of the characteristics of growth failure, including decreased sexual maturation, and impairments in taste acuity and appetite are consistent with zinc deficiency. The present study has attempted to evaluate the status of five adolescents with IBD and growth failure with respect to zinc assimilation. Anthropometric evaluations showed decreased linear growth and delayed skeletal maturation. Dietary intake (calories) averaged 88% of the Recommended Dietary Allowance (RDA) for age, protein intake averaged 138% while zinc averaged 65% of the RDA. It was found that serum zinc levels were depressed in four out of five subjects. These levels did not correlate with albumin levels, but did with somatomedin C levels, a factor which controls growth hormone. Iron deficiency anemia was seen in all five subjects. All subjects had increased fecal losses of nitrogen and [alpha]-1-antitrypsin and four out of five subjects had excessive losses of endogenous zinc. Zinc absorption, based on the stable isotope 70ZN, was normal in one, increased in another and decreased in three subjects. On the basis of these limited observations, we support the conclusion that zinc deficiency is a common complication of Crohn's disease and may be due to inadequate intake, decreased absorption and/or increased losses of zinc.