Nova Esther, Lopez-Vidriero Irene, Varela Pilar, Toro Olga, Casas J José, Marcos A Ascensión
Departamento de Metabolismo y Nutrición, Instituto del Frio, CSIC, C/Jose Antonio Novais 10, Madrid 28040, Spain.
Clin Nutr. 2004 Dec;23(6):1353-9. doi: 10.1016/j.clnu.2004.05.004.
Despite severely reduced intakes, anorexia nervosa (AN) patients seem to maintain serum biochemical parameters within the safe limit. The aim of this study was to assess the evolution of some traditional serum biochemical indicators of nutritional status in a 1-year follow-up of patients with restricting-type AN.
14 adolescent female patients were studied at four different time points: (1) on hospital admission (t0), (2) 1 month later (t1), (3) 6 months after admission (t6) and (4) 12 months after admission (t12). At each time point serum albumin, prealbumin, retinol-binding protein, transferrin, complement factors C3 and C4, zinc and iron status were analysed. 15 healthy adolescents formed the control group.
Among the liver-synthesised proteins, a significant time effect was only demonstrated on transferrin and C3 and C4 (ANOVA, P<0.05). Transferrin level in patients on admission was lower than in controls, increased significantly during the first month and showed an opposite pattern in subjects gaining and non-gaining weight between t1 and t12, decreasing only in the group failing to gain further weight. C3 and C4 decreased significantly in t12. Changes in ferritin and zinc showed significant negative correlations with changes in anthropometrical parameters.
The changes in transferrin, C3 and C4 levels during the out-patient treatment reveal an increased risk of relapses after 1 year since hospital admission. Ferritin and zinc levels seem to be affected by the nutrient requirements for anabolic processes during nutritional recovery.
尽管神经性厌食症(AN)患者的摄入量大幅减少,但他们的血清生化指标似乎仍维持在安全范围内。本研究旨在评估限制型AN患者在1年随访期间一些传统血清营养状况生化指标的变化情况。
对14名青春期女性患者在四个不同时间点进行研究:(1)入院时(t0),(2)1个月后(t1),(3)入院6个月后(t6),以及(4)入院12个月后(t12)。在每个时间点分析血清白蛋白、前白蛋白、视黄醇结合蛋白、转铁蛋白、补体因子C3和C4、锌和铁的状况。15名健康青少年组成对照组。
在肝脏合成的蛋白质中,仅转铁蛋白以及C3和C4显示出显著的时间效应(方差分析,P<0.05)。患者入院时的转铁蛋白水平低于对照组,在第一个月显著升高,并且在t1至t12期间体重增加和未增加的受试者中呈现相反的模式,仅在未能进一步增重的组中下降。C3和C4在t12时显著下降。铁蛋白和锌的变化与人体测量参数的变化呈显著负相关。
门诊治疗期间转铁蛋白、C3和C4水平的变化表明,自入院1年后复发风险增加。铁蛋白和锌水平似乎受营养恢复过程中合成代谢过程的营养需求影响。