Suppr超能文献

肝移植术后患者的营养状况、血脂谱及胰岛素抵抗指数

Nutritional status, lipid profile and HOMA-IR in post-liver transplant patients.

作者信息

Da Silva Alves Vanessa, Hack Mendes Roberta, Pinto Kruel Cleber Dario

机构信息

Programa de Pós-graduação em Medicina: Ciências Cirúrgicas. Faculdade de Medicina. Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul. Brasil..

Observatório de Epidemiologia Nutricional, Instituto de Nutrição Josué de Castro. Universidade Federal do Rio de Janeiro. Rio de Janeiro. Brasil..

出版信息

Nutr Hosp. 2014 May 1;29(5):1154-62. doi: 10.3305/nh.2014.29.5.6861.

Abstract

INTRODUCTION

A high prevalence of overweight, obesity, diabetes and dyslipidemia has been reported following liver transplantation (LT). Although these conditions are known to induce an increased risk for cardiovascular events, which are among the major causes of death in post-LT patients, much debate remains in the literature regarding the applicability of different nutritional assessments methods to this population.

OBJECTIVE

To assess the nutritional status, lipid profile, homeostatic model assessment of insulin resistance (HOMA-IR) and dietary intake adequacy in the post-LT period.

METHODS

Cross-sectional study of patients after a maximum of 2 years post-LT, involving the assessment of body mass index (BMI), percent weight loss, arm (AC) and arm muscle circumference (AMC), triceps skinfold (TSF), neck (NC) and waist (WC) circumference, lipid profile, HOMA-IR and percent adequacy of dietary intake.

RESULTS

In the group of 36 patients, 61.1% were male, mean age 53.2 years (± 10.6). Severe weight loss was noted in 66.7% of patients. Most individuals were eutrophic according to BMI, AC and AMC, while TSF showed malnutrition, NC demonstrated overweight and WC showed metabolic risk. Dyslipidemia was diagnosed in 87.5% of patients, and insulin resistance in 57% of the patients. Most patients had adequate dietary intake, although the time since transplant was positively correlated with AC (r = 0.353; p = 0.035) and negatively correlated with vitamin A intake (r = - 0.382; p = 0.022), with the caloric adequacy (r = -0.338; p = 0.044) and vitamin A adequacy (r = -0.382; p = 0.021).

CONCLUSION

Although anthropometry provided somewhat variable nutritional diagnoses, when combined with biochemical tests, findings showed the prevalence of cardiovascular risk. As such, patients should be provided with transdisciplinary assistance, and strategies should be developed so as to reduce the risk factors recorded in this population.

摘要

引言

据报道,肝移植(LT)后超重、肥胖、糖尿病和血脂异常的患病率很高。尽管已知这些情况会增加心血管事件的风险,而心血管事件是肝移植术后患者的主要死亡原因之一,但关于不同营养评估方法在该人群中的适用性,文献中仍存在很多争议。

目的

评估肝移植术后的营养状况、血脂谱、胰岛素抵抗的稳态模型评估(HOMA-IR)和饮食摄入充足率。

方法

对肝移植术后最多2年的患者进行横断面研究,包括评估体重指数(BMI)、体重减轻百分比、上臂围(AC)和上臂肌肉围(AMC)、肱三头肌皮褶厚度(TSF)、颈围(NC)和腰围(WC)、血脂谱、HOMA-IR和饮食摄入充足率百分比。

结果

在36例患者组中,61.1%为男性,平均年龄53.2岁(±10.6)。66.7%的患者出现严重体重减轻。根据BMI、AC和AMC,大多数个体营养状况正常,而TSF显示营养不良,NC显示超重,WC显示代谢风险。87.5%的患者被诊断为血脂异常,57%的患者存在胰岛素抵抗。大多数患者饮食摄入充足,尽管移植后的时间与AC呈正相关(r = 0.353;p = 0.035),与维生素A摄入量呈负相关(r = -0.382;p = 0.022),与热量充足率(r = -0.338;p = 0.044)和维生素A充足率(r = -0.382;p = 0.021)呈负相关。

结论

尽管人体测量提供的营养诊断存在一定差异,但与生化测试相结合时,结果显示心血管风险的患病率。因此,应为患者提供跨学科的帮助,并制定策略以降低该人群中记录的危险因素。

文献检索

告别复杂PubMed语法,用中文像聊天一样搜索,搜遍4000万医学文献。AI智能推荐,让科研检索更轻松。

立即免费搜索

文件翻译

保留排版,准确专业,支持PDF/Word/PPT等文件格式,支持 12+语言互译。

免费翻译文档

深度研究

AI帮你快速写综述,25分钟生成高质量综述,智能提取关键信息,辅助科研写作。

立即免费体验