Depression and anxiety have been described to occur at higher rates in inflammatory bowel disease (IBD) patients as compared to non-IBD controls. Patients with IBD have been shown to be at risk for nutritional deficiencies, including low zinc. Lower levels of zinc have been associated with increased rates of anxiety and depression in non IBD populations. Our study aim was to determine if lower zinc levels are associated with increased rates of anxiety and depression in pediatric IBD patients.Methods:
Data was obtained via a retrospective chart review of patients seen in the pediatric IBD clinic at Penn State Hershey from April 1, 2014 ro March 19, 2016 including abstraction of zinc levels, Center for Epidemiological Studies (CES) Depression Scale for Children scores and the Screen for Child Anxiety Related Disorders (SCARED) scores.Results:
One hundred ten patients were seen in the clinic of which 18 had ulcerative colitis (UC), 88 were classified as Croh's disease (CD) and 4 with indeterminate colitis. Disease duration of all patients ranged from 0 to 12.4 years with a median of 1.67 (IQR 0.17–3.67). CRP levels ranged from 0.03 to 12.6 mg/dL with median of 0.78 (IQR 0.4–1.16) and normal less than 0.05 mg/dL. Zinc levels ranged from 43 to 141 mcg/dL with median of 68.5 (IQR 60–76) with normal at our lab ranging from 46 to 130 mcg/dL. SCARED scores in Crohn's patients ranged from 0 to 61, with median of 16 (IQR 9–29) and negative screen with score of less than 24. SCARED scores in UC patients ranged from 4 to 36, with median of 17 (IQR 8–27). Depression scores in UC ranged from 1 to 33 with median of 10.5 (IQR 2–17) with negative screen with score of less than 15. Depression scores in Crohn's patients ranged from 0 to 44 with median of 8 (IQR 4–15). Spearman correlation of zinc levels with Depression scores in UC patients was −0.57 (moderate). No correlation was found between zinc levels and anxiety scores in UC patients (Spearman correlation = −0.12), zinc levels and anxiety scores in CD (Spearman correlation = 0.03) or zinc levels and depression scores in CD (Spearman correlation = −0.10).Conclusions:
In our pediatric population, patients with ulcerative colitis had a moderate correlation of increasing depression scores as zinc levels decline. Further study is needed in a larger population to validate these findings and determine if treatment of low zinc levels in UC patients decreases the rates of anxiety or depression.