Essential fatty acid depletion in children with inflammatory bowel disease

Objective Children with inflammatory bowel disease (IBD) suffer from malabsorption and malnutrition and therefore may be at risk of developing polyunsaturated fatty acid (PUFA) deficiency. The aim of this study was to investigate PUFA status in children with IBD and the possible relationship to disease activity and nutritional status. Material and methods We assessed the fatty acid composition of plasma phospholipids (%wt/wt) of 21 children aged 5.5–18 years with IBD (ulcerative colitis, 15; Crohn's disease, 6) with mild or moderate disease activity. The clinical symptoms and biochemical indices of disease activity and nutritional status (lean and fat body mass, Hb, albumin serum conc.) were also determined. Results The patients had lower phospholipid PUFAs than 13 healthy, aged-matched controls (25.8±5.2 versus 34.2±5.7, M±SD, p<0.001), mainly due to lower values of linoleic acid (18:2n−6, 14.0±3.8 versus 18.3±4.3, p<0.01) and its major metabolite arachidonic acid (20:4n−6, 5.3±2.0 versus 9.3±1.9, p<0.0001). There were also higher values of α-linolenic acid (18:3n−3, 0.3±0.4 versus 0.2±0.1, p<0.01) while the long-chain n−3 PUFA-eicosapentaenoic and docosahexaenoic acids were normal. Total n−6 PUFA correlated inversely to erythrocyte sedimentation rate (p<0.01), seromucoid (p<0.05) and positively to Hb concentration (p<0.01). Conclusions Children with inflammatory bowel disease have a high risk of n−6 PUFA depletion, which is related to disease activity.

[1]  S. Wootton,et al.  Essential fatty acid status in paediatric Crohn's disease: relationship with disease activity and nutritional status , 2003, Alimentary pharmacology & therapeutics.

[2]  J. Hunter,et al.  A double‐blind, randomized, placebo‐controlled trial of essential fatty acid supplementation in the maintenance of remission of ulcerative colitis , 2002, Alimentary pharmacology & therapeutics.

[3]  A. Lapillonne,et al.  Polyunsaturated fatty acids and infant growth , 2001, Lipids.

[4]  B. Koletzko,et al.  Essential fatty acid status in children with cholestasis, in relation to serum bilirubin concentration. , 1997, The Journal of pediatrics.

[5]  L. Dubé,et al.  A trial of zileuton versus mesalazine or placebo in the maintenance of remission of ulcerative colitis. The European Zileuton Study Group For Ulcerative Colitis. , 1997, Gastroenterology.

[6]  R. Haggitt,et al.  Leukotrienes in ulcerative colitis: results of a multicenter trial of a leukotriene biosynthesis inhibitor, MK-591. , 1997, Gastroenterology.

[7]  M. Campieri,et al.  Effect of an enteric-coated fish-oil preparation on relapses in Crohn's disease. , 1996, The New England journal of medicine.

[8]  B. Koletzko,et al.  Long-chain polyunsaturated fatty acids in children with severe protein-energy malnutrition with and without human immunodeficiency virus-1 infection. , 1995, The American journal of clinical nutrition.

[9]  J. Sayre,et al.  Decreased bone density in inflammatory bowel disease is related to corticosteroid use and not disease diagnosis , 1995, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[10]  E. Cabré,et al.  Abnormal plasma polyunsaturated fatty acid pattern in non-active inflammatory bowel disease. , 1993, Gut.

[11]  L. Turnberg,et al.  Use of coculture of colonic mucosal biopsies to investigate the release of eicosanoids by inflamed and uninflamed mucosa from patients with inflammatory bowel disease. , 1992, Gut.

[12]  E. Cabré,et al.  Plasma polyunsaturated fatty acid pattern in active inflammatory bowel disease. , 1992, Gut.

[13]  T. Gramlich,et al.  Dietary Supplementation with Fish Oil in Ulcerative Colitis , 1992, Annals of Internal Medicine.

[14]  C. Smith,et al.  Incorporation of fatty acids from fish oil and olive oil into colonic mucosal lipids and effects upon eicosanoid synthesis in inflammatory bowel disease. , 1991, Gut.

[15]  J T Boyle,et al.  Development and validation of a pediatric Crohn's disease activity index. , 1991, Journal of pediatric gastroenterology and nutrition.

[16]  J. Rask-Madsen,et al.  In vivo profiles of eicosanoids in ulcerative colitis, Crohn's colitis, and Clostridium difficile colitis. , 1988, Gastroenterology.

[17]  M. Donowitz,et al.  Arachidonic acid metabolites and their role in inflammatory bowel disease. An update requiring addition of a pathway. , 1985, Gastroenterology.

[18]  T. Cole,et al.  Weight-for-height indices to assess nutritional status--a new index on a slide-rule. , 1981, The American journal of clinical nutrition.

[19]  M. Kutner,et al.  A method of screening for growth hormone deficiency using anthropometrics. , 1981, The American journal of clinical nutrition.

[20]  D. Rampton,et al.  Rectal mucosal prostaglandin E2 release and its relation to disease activity, electrical potential difference, and treatment in ulcerative colitis. , 1980, Gut.

[21]  A. D. De leenheer,et al.  Simultaneous determination of retinol and α-tocopherol in human serum by high-performance liquid chromatography , 1979 .

[22]  K. Yagi,et al.  A simple fluorometric assay for lipoperoxide in blood plasma. , 1976, Biochemical medicine.

[23]  S. Truelove,et al.  Cortisone in Ulcerative Colitis , 1954 .

[24]  B. Koletzko,et al.  Fatty acid composition of plasma lipid classes in healthy subjects from birth to young adulthood , 2005, European Journal of Pediatrics.

[25]  H. Bremer,et al.  Effects of dietary long-chain polyunsaturated fatty acids on the essential fatty acid status of premature infants , 2004, European Journal of Pediatrics.

[26]  D. Molnár,et al.  The effect of under- and overnutrition on essential fatty acid metabolism in childhood , 1998, European Journal of Clinical Nutrition.

[27]  S. Truelove,et al.  Cortisone in ulcerative colitis; final report on a therapeutic trial. , 1955, British medical journal.