Assessment of Serum Iron, Zinc, and Calcium Levels in Children with Pica: A Case–Control Study at a Tertiary Care Hospital

Resumen

A disorder of eating and feeding characterized by persistent eating of non-food/non-nutritive substances, typically over extended time periods, and common in young children. Iron deficiency and zinc and calcium deficiencies are among the nutrients with a strong association to pica, and calcium deficiency is emerging as a potential cause of pica. We recommend comparison of children with pica's iron and zinc and calcium levels to age matched healthy control children, and a study of the relationship between micronutrient deficiencies and pica. A case–control study was conducted at the hospital among 188 children aged 2-6 years (94 cases and 94 controls). Venous blood samples were drawn for estimation of serum iron, zinc and calcium levels and the standard biochemical methods were employed. The data were analysed by SPSS version 16. Independent t-tests were used to compare continuous variables and a p value of < 0.05 was deemed to be statistically significant. Children with pica had significantly lower mean serum iron (42.8 ± 9.4 µg/dL), zinc (61.2 ± 5.1 µg/dL), and calcium (9.8 ± 0.4 mg/dL) than controls (51.6 ± 10.2 µg/dL, 109.4 ± 8.9 µg/dL, and 10.3 ± 0.5 mg/dL, respectively; p < 0.001). Markedly higher prevalence of iron deficiency (72.3%), zinc deficiency (78.7%) and hypocalcaemia (38.3%) was observed in children with pica. Iron, zinc and calcium deficiencies are significantly associated with pica. Early assessment and supplementation of nutrients during the course of the illness can improve the diagnosis, management and prevention of pica in children.