在患有慢性病的儿童中查蛋白质能量浪费,使用双能量X射线吸收计作为额外的工具
Sanjay Yadav1, Uma S Ali2, Manoj Deshmukh3
1Department of Pediatrics, Lilavati Hospital and Research Centre, A 791, Bandra Reclamation, Gen Arun Kumar Vaidya Nagar, Bandra West, Mumbai, 400050, India.
Pediatric nephrology (Berlin, Germany)
|July 29, 2023
概括
蛋白质能量浪费 (PEW) 在患有慢性病 (CKD) 的儿童中非常普遍,特别是在晚期. 通过DEXA测量的瘦身量减少 (LBMr) 是检测PEW的敏感指标,即使在亚临床情况下也是如此.
科学领域:
- 儿科脏病学 儿科脏病学
- 营养科学 营养科学
- 生物标志物 生物标志物
背景情况:
- 目前的蛋白质能量浪费 (PEW) 诊断系统在评估肌肉缺陷方面缺乏精度.
- 准确的PEW诊断对于治疗慢性病 (CKD) 的儿童至关重要.
研究的目的:
- 为了确定PEW在患有CKD的儿童中的患病率.
- 评估双能X射线吸收计 (DEXA) 在PEW诊断中测量瘦体质量 (LBM) 的实用性.
- 为了确定与PEW相关的流行标志物在儿科CKD.
主要方法:
- 一项涉及30名患有CKD的儿童和20名健康对照 (年龄1-18岁) 的横截面研究.
- 评估包括饮食中的蛋白质摄入量 (DPI),身高年龄的BMI (BMI/HA),血清标志物 (白蛋白,胆固醇,CRP) 和身高年龄的LBM (LBMr) 通过DEXA.
- PEW的得分是使用结合这些参数和高度Z-score的系统得分的.
主要成果:
- 20名患有CKD的儿童 (66.7%) 呈现PEW,晚期CKD的患病率和严重程度更高.
- 在100%的PEW病例中观察到瘦体质量减少 (LBMr),显示出高灵敏度.
- 还注意到DPI降低 (80%) 和低BMI/HA (30%);LBMr识别了没有其他PEW标志物的病例.
结论:
- 蛋白质能量浪费 (PEW) 在儿科CKD中非常普遍,随着疾病的严重程度而增加.
- 通过DEXA测量的瘦身量减少 (LBMr) 是该人群中PEW的高度敏感标志物.
- 在不符合其他诊断标准的CKD儿童中,LBMr可能检测出亚临床PEW.
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