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胆道闭锁和自身免疫性肝炎患者的营养状况与血清维生素A、D和E水平的关系

Nutritional status of patients with biliary atresia and autoimmune hepatitis related to serum levels of vitamins A, D and E.

作者信息

Saron Margareth L G, Godoy Helena T, Hessel Gabriel

机构信息

Department of Pediatrics, Universidade Estadual de Campinas, Campinas, SP, Brazil.

出版信息

Arq Gastroenterol. 2009 Jan-Mar;46(1):62-8. doi: 10.1590/s0004-28032009000100016.

Abstract

CONTEXT

Chronic liver disease may induce to malabsorption of lipids and fat-soluble vitamins, leading to injury of nutritional status.

OBJECTIVES

To evaluate the nutritional status of pediatric-age patients with autoimmune hepatitis and biliary atresia related to serum levels of vitamins A, D and E and the disease severity.

METHODS

This controlled transverse study, evaluated the patients with autoimmune hepatitis and biliary atresia and a reference group paired by sex and age. The patients underwent anthropometric evaluation, alimentary inquiry and determination of serum levels of vitamins A, D and E by high performance liquid chromatography. The Mann-Whitney test, Spearman correlation coefficients and variance analysis (ANOVA) were utilized for data treatment, regarding significant difference if P<0.05.

RESULTS

The highest nutritional deficit was observed in patients with biliary atresia, mainly with cholestasis. The serum levels of vitamins A and E for the reference group changed as a function of age. The serum levels of vitamins A, D and E were higher in reference group than in patients with biliary atresia and autoimmune hepatitis together or separately. There were not difference in the serum levels of vitamins A, D and E between biliary atresia groups with cholestasis and without cholestasis. It was verified correlation between weight/age, triceps skinfold thickness, subscapular skinfold thickness, midarm circumference, midarm fat area values and vitamin A serum levels, as well as between all anthropometric indicators and vitamin E in patients with autoimmune hepatitis and biliary atresia.

CONCLUSION

The patients with biliary atresia and cholestasis presented the highest nutritional injury. The patients with biliary atresia and autoimmune hepatitis presented lower serum levels of vitamins A, D and E that in control group. There is a directly proportional correlation between vitamin serum levels, mainly vitamin E, and all anthropometric variables of biliary atresia and autoimmune hepatitis groups.

摘要

背景

慢性肝病可能导致脂质和脂溶性维生素吸收不良,从而损害营养状况。

目的

评估自身免疫性肝炎和胆道闭锁的儿童患者的营养状况与维生素A、D和E血清水平及疾病严重程度的关系。

方法

本对照横断面研究评估了自身免疫性肝炎和胆道闭锁患者以及按性别和年龄配对的参照组。患者接受人体测量评估、饮食询问,并通过高效液相色谱法测定血清维生素A、D和E水平。采用曼-惠特尼检验、斯皮尔曼相关系数和方差分析(ANOVA)进行数据处理,P<0.05为有显著差异。

结果

在胆道闭锁患者中观察到最高的营养缺乏,主要是胆汁淤积患者。参照组的维生素A和E血清水平随年龄变化。参照组的维生素A、D和E血清水平高于胆道闭锁患者和自身免疫性肝炎患者合并或单独的水平。有胆汁淤积和无胆汁淤积的胆道闭锁组之间维生素A、D和E血清水平无差异。在自身免疫性肝炎和胆道闭锁患者中,体重/年龄、肱三头肌皮褶厚度、肩胛下皮褶厚度、上臂围、上臂脂肪面积值与维生素A血清水平之间以及所有人体测量指标与维生素E之间均存在相关性。

结论

胆道闭锁和胆汁淤积患者的营养损伤最严重。胆道闭锁和自身免疫性肝炎患者的维生素A、D和E血清水平低于对照组。维生素血清水平,主要是维生素E,与胆道闭锁和自身免疫性肝炎组的所有人体测量变量之间存在直接比例相关性。

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