Vitamins & Minerals

Background: Inflammatory Bowel Disease (IBD), which includes Ulcerative Colitis (UC) and Crohn’s Disease
(CD), carries an increased risk of micronutrient deficiencies. There are no previous data in this respect regarding
Mexican patients, and as genetic and cultural context can make their nutritional state differ.
Objective: The aim of this study is to describe the frequency of Vitamin D (VD), Cobalamin (Cbl), Zinc and folic
acid (B9) deficiencies in Mexican patients with IBD.
Methods: We reviewed medical records from 270 patients with IBD belonging to the Inflammatory Bowel Disease
Clinic at the National Institute of Medical Science and Nutrition Salvador Zubirán. Clinical and sociodemographic data
were registered. Statistical analysis was performed using the following cut points: VD insufficiency (21-29 ng/mL), VD
deficiency (<20 ng/mL), Cbl deficiency (<180 pg/mL), Zinc deficiency (<60 μg/dl) and B9 deficiency (<6 ng/mL).
Results: Of the total 270 patients studied, 224 had UC (82.96%) and 46 (17.03%) CD. A total of 225 had VD
registered measures, from them, 108 (48%) VD insufficiency and 76 (33.8%) VD deficiency; 159 (58.9%) patients had
registered Cbl levels, from them, 22 (13.8%) showed deficient levels. Of the 71 (26.29%) patients with registered Zinc
serum levels, 5 (7%) presented deficiency. From the 166 (61.48%) patients with B9 registered levels, deficiency was
found in 5 (3.01%) of them.
Conclusion: The frequency of micronutrient deficiencies in IBD patients was: 48% for VD insufficiency, 33.8% for
VD deficiency; 13.8% for Cbl deficiency, 7% for Zinc deficiency and 3.01% for B9 deficiency.

Introduction: Public health programs aimed at identifying and monitoring individuals at risk of specific nutrient
deficiencies may benefit from advances in biospecimen sampling techniques that allow for easier in-the-field collections.
Such advances may be particularly important for those of childbearing potential, in order to identify individuals at risk
of low folate status due to sub-optimal nutriture. Folate is a critical nutrient of interest among women of childbearing
potential because suboptimal levels are a primary contributor to neural tube defects. Whatman Paper Dried Blood
Spots (WDBS) are a convenient method for assessing folate; however, a major drawback of WDBS has been the
inability to separate serum from erythrocyte folate in these samples.
Aim of study: The purpose of this study was to test the feasibility of using newer linear flow chromatography DBS
cards to measure serum and erythrocyte folate.
Method: A convenience sample (n=27) was recruited to assess folate values collected by venous blood draw,
Whatman paper, and linear flow chromatography cards. These sampling techniques allowed for assessment of
erythrocyte and serum folate values collected via different methods. Folate levels in the samples were assessed using
standard Lactobacillus casei microbiological assays.
Results: Erythrocyte folate values from the two blood spot methodologies (Whatman paper and linear flow
chromatography DBS) indicate a strong linear relationship, with 92% of variance accounted for in a linear regression
analysis. Similarly, venous blood samples and linear flow chromatography DBS values accounted for 88% of the
variance.
Conclusion: Linear flow chromatography dried blood spot cards are useful for assessment of erythrocyte and
serum folate. Values had a strong, positive, linear relationship to serum and erythrocyte folate values from other
validated methodologies, including Whatman dried blood spots and venous whole blood samples.