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Micronutrient deficiencies in pediatric short bowel syndrome: a 10-year review from an intestinal rehabilitation center in China

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Abstract

Purpose

Vitamins and trace elements are essential nutrients for growth and intestinal adaptation in children with short bowel syndrome (SBS). This study aimed to assess micronutrients’ status during and after weaning off PN in pediatric SBS.

Methods

This retrospective study evaluated the follow-up of 31 children with SBS between Jan 2010 and Sep 2019. Clinical data were reviewed from the patients’ electric medical record. Serum electrolytes, trace elements, vitamin B12, vitamin D, and folate concentrations were collected before and after enteral autonomy.

Results

Thirty-one SBS cases were reviewed (median onset age 11 days after birth, 51.6% boys, mean PN duration 4 months, and mean residual small intestine length 58.2 cm). Median duration of follow-up was 10 months (interquartile range [IQR]: 4, 19). The common micronutrient deficiencies were zinc (51.6%), copper (38.7%), vitamin D (32.3%), and phosphorus (25.8%) after the transition to EN. The proportion of patients deficient in vitamin D decreased dramatically from 93.5% to 32.3% (P < 0.001), and serum concentrations of vitamin D increased significantly (27.4 ± 12.3 vs. 60.3 ± 32.9 nmol/l, P = 0.03) after achieving full enteral feeding more than 1 month. Additionally, serum magnesium levels significantly increased (0.76 ± 0.17 vs. 0.88 ± 0.14 mmol/l, P = 0.03). Hemoglobin levels elevated significantly after weaning off PN (104.3 ± 10.7 vs. 117.8 ± 13.7 g/l, P = 0.03).

Conclusions

Micronutrient deficiencies remain a common problem in pediatric SBS through intestinal rehabilitation. Therefore, we strongly recommend supplementation of more vitamin D and trace elements (zinc, copper, and phosphorus) under regular monitoring during long-term intestinal rehabilitation.

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Acknowledgements

Not applicable.

Funding

This work was supported by National Natural Science Foundation of China (81974066, 81630039), Foundation of Shanghai Municipal Health Commission (Key Weak Discipline Construction Project), Foundation of Shanghai Municipal Health Commission (shslczdzk05702), and Foundation of Science and Technology Commission of Shanghai Municipality (19495810500).

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Authors and Affiliations

  1. Division of Pediatric Gastroenterology and Nutrition; School of Medicine, Xinhua Hospital, Shanghai Jiao Tong University, No.1665, KongJiang Road, Shanghai, 200082, China

    Haixia Feng, Weihui Yan, Lina Lu, Yijng Tao & Ying Wang

  2. Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition, Shanghai, China

    Wei Cai

  3. Shanghai Institute for Pediatric Research, Shanghai, China

    Wei Cai

  4. Department of Pediatric Surgery, School of Medicine, Xinhua Hospital, Shanghai Jiao Tong University, Shanghai, 200082, China

    Tian Zhang & Wei Cai

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  1. Haixia Feng
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  2. Tian Zhang
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  3. Weihui Yan
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  4. Lina Lu
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  5. Yijng Tao
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  6. Wei Cai
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  7. Ying Wang
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Correspondence to Ying Wang.

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Written informed consent was obtained from patient’s parents to publish this study. This material is original research. It has not been previously published and has not been submitted for publication elsewhere while under consideration.

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Feng, H., Zhang, T., Yan, W. et al. Micronutrient deficiencies in pediatric short bowel syndrome: a 10-year review from an intestinal rehabilitation center in China. Pediatr Surg Int 36, 1481–1487 (2020). https://doi.org/10.1007/s00383-020-04764-3

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