儿童克罗恩病中的必需脂肪酸状况：与疾病活动及营养状况的关系

Essential fatty acid status in paediatric Crohn's disease: relationship with disease activity and nutritional status.

作者信息

Trebble T M, Wootton S A, May A, Erlewyn-Lajeunesse M D S, Chakraborty A, Mullee M A, Stroud M A, Beattie R M

机构信息

Institute of Human Nutrition, School of Medicine, University of Southampton, Southampton, UK.

出版信息

Aliment Pharmacol Ther. 2003 Aug 15;18(4):433-42. doi: 10.1046/j.1365-2036.2003.01707.x.

DOI:10.1046/j.1365-2036.2003.01707.x

PMID:12940929

Abstract

BACKGROUND

Active paediatric Crohn's disease is associated with nutritional deficiencies and altered nutrient intake. The availability of essential fatty acids (linoleic and alpha-linolenic acids) or their derivatives (arachidonic and eicosapentaenoic acids) may alter in plasma and cell membrane phospholipid in protein-energy malnutrition in children and in Crohn's disease in adults.

AIM

To investigate the relationship of fatty acid phospholipid profiles with disease activity and nutritional status in paediatric Crohn's disease.

METHODS

The fatty acid (proportionate) composition of plasma and erythrocyte phosphatidylcholine was determined in 30 patients (10.3-17.0 years) stratified into active and quiescent Crohn's disease (paediatric Crohn's disease activity index) and high and low body mass (body mass index centile).

RESULTS

In plasma phosphatidylcholine, active disease activity was associated with a lower level of alpha-linolenic acid compared with that in quiescent disease (P < 0.05). A body mass index below the 50th centile was associated with active Crohn's disease, low linoleic and alpha-linolenic acids and high arachidonic acid (P < 0.05) in plasma phosphatidylcholine, and low alpha-linolenic acid in erythrocyte phosphatidylcholine. These findings could not be explained through differences in habitual dietary fat intake.

CONCLUSION

In paediatric Crohn's disease, a low body mass index centile and high disease activity are associated with altered profiles of essential fatty acids and their derivatives, which may reflect altered metabolic demand.

摘要

背景

儿童活动性克罗恩病与营养缺乏及营养摄入改变有关。在儿童蛋白质 - 能量营养不良及成人克罗恩病中，必需脂肪酸（亚油酸和α - 亚麻酸）或其衍生物（花生四烯酸和二十碳五烯酸）在血浆和细胞膜磷脂中的含量可能会发生变化。

目的

研究儿童克罗恩病中脂肪酸磷脂谱与疾病活动度及营养状况的关系。

方法

对30例年龄在10.3 - 17.0岁的患者进行分层，分为活动性和静止性克罗恩病（儿童克罗恩病活动指数）以及高体重和低体重（体重指数百分位数）组，测定其血浆和红细胞磷脂酰胆碱的脂肪酸（比例）组成。

结果

在血浆磷脂酰胆碱中，与静止期疾病相比，活动性疾病活动度与较低水平的α - 亚麻酸相关（P < 0.05）。体重指数低于第50百分位数与活动性克罗恩病、血浆磷脂酰胆碱中亚油酸和α - 亚麻酸水平低以及花生四烯酸水平高相关（P < 0.05），红细胞磷脂酰胆碱中α - 亚麻酸水平低。这些发现无法通过习惯性饮食脂肪摄入量的差异来解释。