Location: Children's Nutrition Research CenterTitle: Trace mineral absorption status in infants with ileostomies Author
Submitted to: Pediatric Academic Society
Publication Type: Abstract Only
Publication Acceptance Date: 1/28/2010
Publication Date: 5/3/2010
Citation: Balay, K., Cooley, R., Chen, Z., Hicks, P., Hawthorne, K., Abrams, S. 2010. Trace mineral absorption status in infants with ileostomies [abstract]. Annual Meeting of the Pediatric Academic Society, May 1-4, 2010, Vancouver, BC Canada. E-PAS2010:3737.383. Interpretive Summary:
Technical Abstract: Infants with ileostomies are often supplemented with zinc and limited in copper, because of potential increased bilious zinc loss and increased cholestasis due to reduced copper excretion. However, no data exist on zinc or copper balance in infants with ileostomies. To determine the effect of an ileostomy on zinc and copper status and zinc absorption in neonates, baseline values for serum zinc, copper, and ceruloplasmin were obtained. We performed dual tracer stable isotope studies of zinc absorption from enteral feeds at point 1, when infants were receiving primarily enteral nutrition without parenteral nutrition and at point 2 , after reanastamosis of the bowel and ileostomy take-down. We have studied 11 subjects to date for baseline or absorption data. Baseline information while on TPN is available for 7 infants. The first study at point 1 was performed on 6 infants. The second study at point 2 was performed on 6 infants (data are paired for 3 of the 6 infants). Serum zinc levels were not deficient in any infants at baseline or at point 1. Zinc was deficient in 1 of 6 babies studied at point 2. Copper and/or ceruloplasmin levels were abnormal in 9 of 11 infants. Normal serum values for zinc, copper, and ceruloplasmin are 60-120 ug/dL, 20-70 ug/dL, and 14-44 mg/dL, respectively. Baseline zinc values were 112.1 +/- 30.1 ug/dL and baseline copper values were 68.0 +/- 28.1 ug/dL. At point 1 zinc levels were 93.8 +/- 26.9 ug/dL and copper levels were 49.0 +/- 24.4 ug/dL. At point 2 zinc levels were 78.3 +/- 32.9 ug/dL and copper levels were 61.5 +/- 29.6 ug/dL. Ceruloplasmin levels were 19.2 +/- 5.9 mg/dL at baseline, 14.5 +/- 5.4 mg/dL at point 1 and 20.0 +/- 8.5 mg/dL at point 2. In 6 patients studied to date, fractional absorption of zinc was 8.4% + 1.5% (Mean + SD) and 8.5% + 4.0% (Mean + SD) before and after ileostomy takedown (normal 20-40%). Fractional absorption of zinc was extremely low before and after takedown of the ileostomy. Zinc and copper deficiencies were common although they may have worsened during enteral feeds due to poor mineral bioavailability.