Tsiountsioura M, Wong J E, Upton J, McIntyre K, Dimakou D, Buchanan E, Cardigan T, Flynn D, Bishop J, Russell R K, Barclay A, McGrogan P, Edwards C, Gerasimidis K
Human Nutrition Unit, School of Medicine, College of Medicine, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK.
1] Human Nutrition Unit, School of Medicine, College of Medicine, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK [2] School of Healthcare Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
Eur J Clin Nutr. 2014 Jun;68(6):700-6. doi: 10.1038/ejcn.2013.286. Epub 2014 Jan 15.
BACKGROUND/OBJECTIVES: In the era of modern multidisciplinary clinical management, very little is known about the prevalence and presentation of malnutrition in children with gastrointestinal disorders (GastroD) particularly employing composite, global measures of nutritional status.
SUBJECTS/METHODS: Anthropometry, body composition, dietary intake, eating habits and grip strength were assessed with bedside methods in 168 patients from outpatient gastroenterology clinics (n, median (IQR) years; Crohn's disease (CD): n=53, 14.2 (11.6:15.4); ulcerative colitis (UC): n=27, 12.2 (10.7:14.2); coeliac disease: n=31, 9.3 (7.5:13.6); other GastroD: n=57, 9.8 (7.2:13.8)) and compared with 62 contemporary healthy controls (n, median (IQR): 9.8 (6.9:13.8)) and the results of the recent UK, National Diet and Nutritional Survey (NDNS).
Children with CD had lower BMI z-scores than controls (median (IQR): -0.3 (-0.9:0.4) vs 0.3 (-0.6:1.4); P=0.02) but only 2% were classified as thin (BMI z-score <-2 s.d.). The prevalence of obesity in children with UC was 19%, 6% in CD, 11% in children with other GastroD and 15% in controls. No difference was found in grip strength measurement between groups. Except for CD children, the proportion of patients with suboptimal micronutrient intake was similar to that of controls and the cohort of children from the latest NDNS. A higher proportion of children with CD had suboptimal intake for riboflavin, vitamin B6 and calcium and consumed significantly more meat products, juices (including carbonated drinks), spreads/jams and crisps and savoury snacks and significantly fewer portions of dairy, fish, fruits and vegetables compared with healthy controls.
GastroD affect children's body composition, growth, strength, dietary intake and eating habits, particularly CD, but to a lesser extent than expected.
背景/目的：在现代多学科临床管理时代，对于患有胃肠道疾病（GastroD）的儿童中营养不良的患病率和表现知之甚少，尤其是采用综合、整体的营养状况衡量指标时。
对象/方法：采用床边方法对168名来自门诊胃肠病诊所的患者（n，中位数（四分位间距）岁；克罗恩病（CD）：n = 53，14.2（11.6:15.4）；溃疡性结肠炎（UC）：n = 27，12.2（10.7:14.2）；乳糜泻：n = 31，9.3（7.5:13.6）；其他胃肠道疾病：n = 57，9.8（7.2:13.8））的人体测量学、身体成分、饮食摄入、饮食习惯和握力进行评估，并与62名当代健康对照者（n，中位数（四分位间距）：9.8（6.9:13.8））以及英国近期的国家饮食与营养调查（NDNS）结果进行比较。
患有CD的儿童的BMI z评分低于对照组（中位数（四分位间距）：-0.3（-0.9:0.4）对0.3（-0.6:1.4）；P = 0.02），但只有2%被归类为消瘦（BMI z评分< -2标准差）。UC患儿的肥胖患病率为19%，CD为6%，其他胃肠道疾病患儿为11%，对照组为15%。各组之间握力测量未发现差异。除CD患儿外，微量营养素摄入不足的患者比例与对照组以及最新NDNS中的儿童队列相似。与健康对照组相比，CD患儿中核黄素、维生素B6和钙摄入不足的比例更高，食用的肉类产品、果汁（包括碳酸饮料）、涂抹酱/果酱、薯片和咸味零食明显更多，而乳制品、鱼类、水果和蔬菜的摄入量明显更少。
胃肠道疾病会影响儿童的身体成分、生长、力量、饮食摄入和饮食习惯，尤其是CD，但程度低于预期。
