Gastroenterology Section, Department of Medicine, Temple University, Philadelphia, Pennsylvania 19140, USA.
Gastroenterology. 2011 Aug;141(2):486-98, 498.e1-7. doi: 10.1053/j.gastro.2011.04.045. Epub 2011 Apr 28.
BACKGROUND & AIMS: Gastroparesis can lead to food aversion, poor oral intake, and subsequent malnutrition. We characterized dietary intake and nutritional deficiencies in patients with diabetic and idiopathic gastroparesis.
Patients with gastroparesis on oral intake (N = 305) were enrolled in the National Institute of Diabetes and Digestive and Kidney Diseases Gastroparesis Registry and completed diet questionnaires at 7 centers. Medical history, gastroparesis symptoms, answers to the Block Food Frequency Questionnaire, and gastric emptying scintigraphy results were analyzed.
Caloric intake averaged 1168 ± 801 kcal/day, amounting to 58% ± 39% of daily total energy requirements (TER). A total of 194 patients (64%) reported caloric-deficient diets, defined as <60% of estimated TER. Only 5 patients (2%) followed a diet suggested for patients with gastroparesis. Deficiencies were present in several vitamins and minerals; patients with idiopathic disorders were more likely to have diets with estimated deficiencies in vitamins A, B(6), C, K, iron, potassium, and zinc than diabetic patients. Only one-third of patients were taking multivitamin supplements. More severe symptoms (bloating and constipation) were characteristic of patients who reported an energy-deficient diet. Overall, 32% of patients had nutritional consultation after the onset of gastroparesis; consultation was more likely among patients with longer duration of symptoms and more hospitalizations and patients with diabetes. Multivariable logistic regression analysis indicated that nutritional consultation increased the chances that daily TER were met (odds ratio, 1.51; P = .08).
Many patients with gastroparesis have diets deficient in calories, vitamins, and minerals. Nutritional consultation is obtained infrequently but is suggested for dietary therapy and to address nutritional deficiencies.
胃轻瘫可导致食物厌恶、口服摄入不良以及随后的营养不良。本研究旨在分析糖尿病性和特发性胃轻瘫患者的饮食摄入和营养缺乏情况。
我们招募了 305 例口服摄入的胃轻瘫患者（N=305），并让他们参与到国立糖尿病、消化和肾脏疾病研究所胃轻瘫登记处，这些患者在 7 个中心完成了饮食问卷。我们分析了他们的病史、胃轻瘫症状、对布洛克食物频率问卷的回答以及胃排空闪烁成像结果。
平均热量摄入为 1168±801kcal/d，相当于每日总能量需求（TER）的 58%±39%。共有 194 例（64%）患者报告存在热量不足的饮食，定义为<60%的估计 TER。仅有 5 例（2%）患者遵循了胃轻瘫患者的饮食建议。几种维生素和矿物质都存在缺乏的情况；与糖尿病患者相比，特发性疾病患者更有可能出现维生素 A、B（6）、C、K、铁、钾和锌的估计缺乏。只有三分之一的患者在服用多种维生素补充剂。症状更严重（腹胀和便秘）的患者更有可能报告存在能量不足的饮食。总体而言，32%的患者在胃轻瘫发病后接受了营养咨询；症状持续时间更长、住院次数更多的患者以及糖尿病患者更有可能接受营养咨询。多变量逻辑回归分析表明，营养咨询增加了达到每日 TER 的可能性（比值比，1.51；P=0.08）。
许多胃轻瘫患者的饮食存在热量、维生素和矿物质缺乏的情况。营养咨询获取频率较低，但它有助于进行饮食治疗和解决营养缺乏问题。
