Hankard Régis, Munck Anne, Navarro Jean
Clinical Investigation Unit, Robert Debré Hospital, Paris, France.
Horm Res. 2002;58 Suppl 1:16-20. doi: 10.1159/000064763.
Malnutrition is a common complication of chronic diseases in children and may lead to growth impairment (stunting). Malnutrition in cystic fibrosis (CF) results from increased energy expenditure, decreased energy intakes, malabsorption of ingested nutrients because of pancreatic insufficiency and chronic inflammation. Malnutrition and high levels of inflammatory cytokines affect IGF-1 production through interrelated mechanisms. Nutritional support was shown to improve both nutritional status and outcome in CF. However, some nutrients have a direct effect on the disease. n-3 fatty acids supplementation is able to correct lipid abnormalities resulting from a primary mechanism. Moreover, n-3 fatty acids have a direct effect on the inflammatory response, decreasing eicosanoid synthesis and modulating nuclear transcriptional factors nuclear factor kappaB and peroxisome proliferator-activated receptors gamma. Nutritional support may be considered part of the care of the CF patient together with antibiotics, pancreatic enzymes and physiotherapy, influencing significantly the evolution of the disease.
营养不良是儿童慢性疾病的常见并发症，可能导致生长发育受损（发育迟缓）。囊性纤维化（CF）患者的营养不良是由能量消耗增加、能量摄入减少、胰腺功能不全和慢性炎症导致摄入营养素吸收不良引起的。营养不良和高水平的炎性细胞因子通过相互关联的机制影响胰岛素样生长因子-1（IGF-1）的产生。营养支持已被证明可改善CF患者的营养状况和预后。然而，一些营养素对该疾病有直接影响。补充n-3脂肪酸能够纠正由主要机制导致的脂质异常。此外，n-3脂肪酸对炎症反应有直接影响，可减少类花生酸的合成，并调节核转录因子核因子κB和过氧化物酶体增殖物激活受体γ。营养支持可与抗生素、胰酶和物理治疗一起被视为CF患者护理的一部分，对疾病的发展有显著影响。
