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苯丙酮尿症老年人对新型维生素和矿物质补充剂的长期依从性。

Long-term compliance with a novel vitamin and mineral supplement in older people with PKU.

作者信息

MacDonald A, Lee P, Davies P, Daly A, Lilburn M, Gokmen Ozel H, Preece M A, Hendriksz C, Chakrapani A

机构信息

Birmingham Children's Hospital, Steelhouse Lane, Birmingham, B4 6NH, UK.

出版信息

J Inherit Metab Dis. 2008 Dec;31(6):718-23. doi: 10.1007/s10545-008-0960-4. Epub 2008 Oct 22.

Abstract

BACKGROUND

The long-term efficacy of vitamin and mineral preparations in dietary-treated adult patients with phenylketonuria (PKU) is unreported.

AIM

In an open, intervention trial, the acceptability, safety and impact on biochemical and haematological micronutrient status of a new vitamin and mineral tablet (Phlexy Vits, SHS International) was investigated.

METHODS

Fifteen subjects with PKU (median age 21 years, range 8-33 years) on low-phenylalanine diet from two PKU centres were recruited. No vitamins or minerals were added to their protein substitute and for 12 months they took their full daily requirements of vitamin and minerals from Phlexy Vits (5 tablets/daily). All but two subjects had taken alternative vitamin and mineral supplements before the trial. Fasting bloods were taken at baseline (week -2 and at week 0), 4 and 12 months for a range of biochemical and nutritional measurements.

RESULTS

By 4 months, serum vitamin B(12) (p = 0.003), serum manganese (p=0.03) and plasma (p=0.03) and red blood cell (p=0.004) glutathionine peroxidase (GSHPx) all significantly increased but remained within normal reference ranges. By 12 months, serum vitamin B(12) (p<0.05) and plasma GSHPx (p<0.05) remained increased. The Phlexy Vits tablets scored better than conventional vitamin and mineral supplements for overall acceptability (p<0.05), and ease of swallowing (p=0.1) at 4 months, although swallowing score deteriorated by 12 months (p<0.05). There was a small but significant deterioration in compliance with taking the vitamin and mineral supplements between 4 and 12 months (p<0.05).

CONCLUSION

In the long term, these comprehensive vitamin and mineral tablets appeared acceptable and improved biochemical nutritional status, although there were long-term compliance and swallowing issues.

摘要

背景

维生素和矿物质制剂对接受饮食治疗的成年苯丙酮尿症(PKU)患者的长期疗效尚无报道。

目的

在一项开放性干预试验中,研究一种新型维生素和矿物质片剂(Phlexy Vits,SHS国际公司)的可接受性、安全性以及对生化和血液学微量营养素状态的影响。

方法

招募了来自两个PKU中心的15名接受低苯丙氨酸饮食的PKU患者(中位年龄21岁,范围8 - 33岁)。他们的蛋白质替代物中未添加维生素或矿物质,在12个月的时间里,他们从Phlexy Vits(每日5片)中获取全部每日所需的维生素和矿物质。除两名受试者外, 所有受试者在试验前都服用过其他维生素和矿物质补充剂。在基线(第 - 2周和第0周)、第4个月和第12个月采集空腹血样,进行一系列生化和营养指标检测。

结果

到第4个月时,血清维生素B12(p = 0.003)、血清锰(p = 0.03)以及血浆(p = 0.03)和红细胞(p = 0.004)谷胱甘肽过氧化物酶(GSHPx)均显著升高,但仍在正常参考范围内。到第12个月时,血清维生素B12(p < 0.05)和血浆GSHPx(p < 0.05)仍保持升高。在总体可接受性方面(p < 0.05),以及在第4个月时的吞咽 ease of swallowing(p = 0.1)方面,Phlexy Vits片剂的评分优于传统维生素和矿物质补充剂,不过到第12个月时吞咽评分有所下降(p < 0.05)。在第4个月至第12个月期间,服用维生素和矿物质补充剂的依从性出现了轻微但显著的下降(p < 0.05)。

结论

从长期来看,这些综合性维生素和矿物质片剂似乎是可接受的,并且改善了生化营养状况,尽管存在长期依从性和吞咽问题。

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