Gordon Catherine M, Anderson Ellen J, Herlyn Karen, Hubbard Jane L, Pizzo Angela, Gelbard Rondi, Lapey Allen, Merkel Peter A
Division of Endocrinology, Children's Hospital Boston, Boston, MA 22015, USA.
J Am Diet Assoc. 2007 Dec;107(12):2114-9. doi: 10.1016/j.jada.2007.09.005.
Nutrition is thought to influence disease status in patients with cystic fibrosis (CF). This cross-sectional study sought to evaluate nutrient intake and anthropometric data from 64 adult outpatients with cystic fibrosis. Nutrient intake from food and supplements was compared with the Dietary Reference Intakes for 16 nutrients and outcomes influenced by nutritional status. Attention was given to vitamin D and calcium given potential skeletal implications due to cystic fibrosis. Measurements included weight, height, body composition, pulmonary function, and serum metabolic parameters. Participants were interviewed about dietary intake, supplement use, pulmonary function, sunlight exposure, and pain. The participants' mean body mass index (+/-standard deviation) was 21.8+/-4.9 and pulmonary function tests were normal. Seventy-eight percent used pancreatic enzyme replacement for malabsorption. Vitamin D deficiency [25-hydroxyvitamin D (25OHD)<37.5 nmol/L] was common: 25 (39%) were deficient despite adequate vitamin D intake. Lipid profiles were normal in the majority, even though total and saturated fat consumption represented 33.0% and 16.8% of energy intake, respectively. Reported protein intake represented 16.9% of total energy intake (range 10%-25%). For several nutrients, including vitamin D and calcium, intake from food and supplements in many participants exceeded recommended Tolerable Upper Intake Levels. Among adults with cystic fibrosis, vitamin D deficiency was common despite reported adequate intake, and lipid profiles were normal despite a relatively high fat intake. Mean protein consumption was adequate, but the range of intake was concerning, as both inadequate or excessive intake may have deleterious skeletal effects. These findings call into question the applicability of established nutrient thresholds for patients with cystic fibrosis.
营养状况被认为会影响囊性纤维化（CF）患者的疾病状态。这项横断面研究旨在评估64名成年囊性纤维化门诊患者的营养摄入情况和人体测量数据。将食物和补充剂中的营养摄入量与16种营养素的膳食参考摄入量以及受营养状况影响的结果进行比较。由于囊性纤维化可能对骨骼产生影响，因此对维生素D和钙给予了关注。测量指标包括体重、身高、身体成分、肺功能和血清代谢参数。研究人员就饮食摄入、补充剂使用、肺功能、阳光照射和疼痛情况对参与者进行了访谈。参与者的平均体重指数（±标准差）为21.8±4.9，肺功能测试结果正常。78%的参与者因吸收不良而使用胰酶替代疗法。维生素D缺乏症[25-羟基维生素D（25OHD）<37.5 nmol/L]很常见：尽管维生素D摄入量充足，但仍有25人（39%）缺乏维生素D。大多数人的血脂谱正常，尽管总脂肪和饱和脂肪的摄入量分别占能量摄入的33.0%和16.8%。报告的蛋白质摄入量占总能量摄入的16.9%（范围为10%-25%）。对于包括维生素D和钙在内的几种营养素，许多参与者从食物和补充剂中摄入的量超过了推荐的可耐受最高摄入量水平。在成年囊性纤维化患者中，尽管报告摄入量充足，但维生素D缺乏症仍很常见；尽管脂肪摄入量相对较高，但血脂谱正常。平均蛋白质摄入量充足，但摄入量范围令人担忧，因为摄入不足或过量都可能对骨骼产生有害影响。这些发现使人质疑既定营养阈值对囊性纤维化患者的适用性。
