Wilkens Knudsen Anne, Jensen Jens-Erik Beck, Nordgaard-Lassen Inge, Almdal Thomas, Kondrup Jens, Becker Ulrik
Gastrounit, Medical Division, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark,
Eur J Nutr. 2014 Oct;53(7):1483-92. doi: 10.1007/s00394-014-0651-x. Epub 2014 Jan 20.
Malnutrition increases the risk of developing alcohol-related complications. The aim of this study was to describe nutrient intake, nutritional status and nutrition-related complications in a Danish population of outpatients with alcohol dependency.
This was a cross-sectional study with a 6-month follow-up enrolling persons with alcohol dependency (n = 80) admitted to a hospital-based outpatient clinic. Body mass index, the waist-to-hip ratio and handgrip strength (HGS) were measured, a 7-day food diary was collected, and biochemical testing was conducted. Dual-energy X-ray absorptiometry was performed to determine body composition and bone mineral density (BMD).
In total, 64% of the patients with alcohol dependency had vitamin D insufficiency (25-OH-vit D <50 nmol/l). Compared with surveys of the general population, the patients with alcohol dependency had lower energy intake (p = 0.008), s-zinc levels (p < 0.001), s-magnesium levels (p = 0.02), Z-scores for BMD (lumbar spine, p = 0.03; total hip, p = 0.009) and HGS (p < 0.001). Osteopenia was observed in 52% of individuals, and overt osteoporosis was noted in 7%. Comparing baseline data with data from the follow-up (n = 30), we found a decrease in s-CRP (p = 0.002) and s-alanine amino transferase (p = 0.01) levels and an increase in s-parathyroid hormone levels (p = 0.02).
Patients with alcohol dependency have an altered nutritional status and risk of complications, as evidenced by osteopenia/osteoporosis and reduced muscle strength. Treatment at an outpatient clinic improved the variables related to liver function, but no change was observed in nutritional status over time. These findings suggest that specific screening and targeted treatment regimens for nutritional deficits could be beneficial.
营养不良会增加发生酒精相关并发症的风险。本研究旨在描述丹麦酒精依赖门诊患者的营养摄入、营养状况及营养相关并发症。
这是一项横断面研究，对一家医院门诊收治的80例酒精依赖患者进行为期6个月的随访。测量体重指数、腰臀比和握力（HGS），收集7天食物日记，并进行生化检测。采用双能X线吸收法测定身体成分和骨密度（BMD）。
总体而言，64%的酒精依赖患者存在维生素D不足（25-羟基维生素D<50 nmol/L）。与普通人群调查相比，酒精依赖患者的能量摄入量较低（p = 0.008）、血清锌水平较低（p<0.001）、血清镁水平较低（p = 0.02）、骨密度Z评分较低（腰椎，p = 0.03；全髋，p = 0.009）以及握力较低（p<0.001）。52%的个体存在骨质减少，7%的个体存在明显骨质疏松。将基线数据与随访数据（n = 30）进行比较，我们发现血清C反应蛋白（p = 0.002）和血清丙氨酸氨基转移酶（p = 0.01）水平降低，血清甲状旁腺激素水平升高（p = 0.02）。
酒精依赖患者的营养状况发生改变且存在并发症风险，骨质减少/骨质疏松和肌肉力量下降证明了这一点。门诊治疗改善了与肝功能相关的变量，但随着时间推移营养状况未观察到变化。这些发现表明针对营养缺乏的特定筛查和靶向治疗方案可能有益。
