Rigaud D, Sogni P, Hammel P, Melchior J C, Angel L, Rozen R, Labarre C, Mignon M, Apfelbaum M
Service de Nutrition, Hôpital Bichat, Paris.
Ann Med Interne (Paris). 1989;140(2):86-90.
One of the most important therapeutic goal in anorexia nervosa is to define with the patient a body weight to obtain. To do so, objective criteria are needed. For this purpose, we studied in a longitudinal way, 9 nutritional parameters in 23 patients with anorexia nervosa, as compared with 23 age - and sex - matched patients with Crohn's disease: body weight, tricep's skinfolds, mid-arm muscle circumferences; serum albumin, prealbumin, transferrin, hemoglobin, cholesterol; urinary creatinine and calcium, magnesium, zinc and copper serum levels and urinary outputs. Despite losses of body weight, of lean body mass and of fatty mass higher in patients with anorexia nervosa than in those with Crohn's disease, the former had higher nutritional protein's serum levels than the latter. These nutritional protein markers were not in anorexia nervosa different from normal values. In anorexia patients, zinc and copper serum levels and urinary outputs were very low. This study suggests that nutritional protein markers of hepatic synthesis are not sensitive markers for malnutrition evaluation and can not be used to follow renutrition efficacy.
神经性厌食症最重要的治疗目标之一是与患者确定一个要达到的体重。为此,需要客观标准。出于这个目的,我们纵向研究了23名神经性厌食症患者的9项营养参数,并与23名年龄和性别匹配的克罗恩病患者进行了比较:体重、肱三头肌皮褶厚度、上臂中部肌肉周长;血清白蛋白、前白蛋白、转铁蛋白、血红蛋白、胆固醇;尿肌酐以及钙、镁、锌和铜的血清水平与尿排出量。尽管神经性厌食症患者的体重、瘦体重和脂肪量的减少比克罗恩病患者更严重,但前者的营养蛋白血清水平高于后者。这些营养蛋白标志物在神经性厌食症中与正常值并无差异。在厌食症患者中,锌和铜的血清水平及尿排出量非常低。这项研究表明,肝脏合成的营养蛋白标志物并非评估营养不良的敏感标志物,不能用于追踪营养恢复的疗效。