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[营养、骨病与酒精性肝硬化]

[Nutrition, bone disease and alcoholic cirrhosis].

作者信息

Escalante Boleas M A, Franco Vicario R, Cubas Largacha L, Goiría Ormazábal J I, Zulueta Gabancho M L, Cabarcos Cazón A, Duque de las Heras C, Miguel de la Villa F

机构信息

Servicio de Medicina Interna, Hospital de Basurto.

出版信息

An Med Interna. 2002 Oct;19(10):503-5.

Abstract

OBJECTIVES

To know the prevalence of osteopenia and osteoporosis in alcoholic cirrhotic males from 45 to 65 years old. To prove if the nutritional state is involved in the loss of bone mass in the hepatic disease.

STUDY POPULATION

52 alcoholic cirrhotic males from 45 to 65 years old, with normal kidney function, non-sedentary and with no treatment that could alterate the study. Design and variables: transversal descriptive study finished in 2 years. The nutritional state was evaluated by means of classic anthropometric parameters (weight, height, perimeter of the arm and skin folds) and total body densitometry (DPX plus LUNAR-DEXA with dual energy X-ray absorptiometry.

STATISTICAL ANALYSIS

Mc Intosh computer (Filemaker PRO program). T Student was used to compare groups and p was significant if alpha alpha < or = 0.05. Clinical severity of cirrhosis: Child-Turcotte classification.

RESULTS

Osteopenia was diagnosed if bone mineral density (BMD) was higher than 1 standard deviation (SD) but lower than 3 SD below T score (mean values for adult women) and osteoporosis (OP) if BMD was higher than 3 SD or vertebral compression fractures appeared in simple radiographies. The prevalence of bone disease was 58%. The percentages of fat obtained by means of anthropometric and densitometric measures were higher in non-osteopenic patients.

DISCUSSION

The prevalence of bone disease was higher than another studies. The total body densitometry is a more exact method to measure the percentage of body fat. The percentages of fat obtained with both methods were not related to the loss of bone mass. The nutritional state as an isolated factor does not lead to bone disease in these patients.

摘要

目的

了解45至65岁酒精性肝硬化男性中骨量减少和骨质疏松症的患病率。验证营养状况是否与肝脏疾病中的骨质流失有关。

研究人群

52名45至65岁的酒精性肝硬化男性,肾功能正常,非久坐不动且未接受可能影响研究的治疗。设计与变量:为期2年的横断面描述性研究。通过经典人体测量参数(体重、身高、臂围和皮褶厚度)和全身骨密度测量(采用双能X线吸收法的DPX加LUNAR - DEXA)评估营养状况。

统计分析

使用Mc Intosh计算机(Filemaker PRO程序)。采用t检验比较组间差异,若α≤0.05,则p值具有统计学意义。肝硬化的临床严重程度:采用Child - Turcotte分类法。

结果

如果骨矿物质密度(BMD)高于1个标准差(SD)但低于T值(成年女性平均值)以下3个SD,则诊断为骨量减少;如果BMD高于3个SD或在普通X光片中出现椎体压缩性骨折,则诊断为骨质疏松症(OP)。骨病患病率为58%。通过人体测量和骨密度测量获得的非骨量减少患者的脂肪百分比更高。

讨论

骨病患病率高于其他研究。全身骨密度测量是测量身体脂肪百分比更准确的方法。两种方法获得的脂肪百分比与骨质流失无关。在这些患者中,营养状况作为一个独立因素不会导致骨病。

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