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苯丙酮尿症患者生长发育的新见解。

New insights in growth of phenylketonuric patients.

作者信息

Couce María L, Guler Ipek, Anca-Couce Andrés, Lojo Marta, Mirás Alicia, Leis Rosaura, Pérez-Muñuzuri Alejandro, Fraga José M, Gude Francisco

机构信息

Unit of Diagnosis and Treatment of Congenital Metabolic Diseases, Department of Pediatrics, Hospital Clínico Universitario de Santiago de Compostela, A Choupana s/n,, 15706, Santiago de Compostela, A Coruña, Spain,

出版信息

Eur J Pediatr. 2015 May;174(5):651-9. doi: 10.1007/s00431-014-2446-8. Epub 2014 Nov 1.

Abstract

UNLABELLED

Treatment of phenylketonuria involves a restriction in the intake of natural proteins. This can lead to growth impairment. Weight, height and body mass index of 109 hyperphenylalaninemic patients (mild hyperphenylalaninemia (HPA) and phenylketonuria (PKU)) were determined from birth until 18 years, every 6 months, and differences to the healthy population, depending on the age, sex and phenotype, were analyzed. Data collection was longitudinal retrospective during 31 years. Statistical analysis of z-score values was performed by advanced statistical tools. Long-term evolution of anthropometric z-scores showed no significant statistical differences between PKU and mild HPA individuals, according to the general population. For PKU individuals, height is slightly lower and weight slightly higher than in the healthy population, but differences are smaller than one standard deviation. Nevertheless, over-time evolutions of female height z-scores are different in each type of pathology, with a crossover between 8 and 12 years (p = 0.0186).

CONCLUSIONS

It is nowadays possible to achieve a long-term normal growth in PKU patients with appropriate dietary treatment. There is however an acceleration of growth up to 8 years old for PKU female patients that leads to a slightly lower final height. Detection of this behaviour was possible by using nonlinear mixed effects models.

摘要

未标注

苯丙酮尿症的治疗涉及限制天然蛋白质的摄入量。这可能导致生长发育受损。对109名高苯丙氨酸血症患者(轻度高苯丙氨酸血症(HPA)和苯丙酮尿症(PKU))从出生到18岁每6个月测定一次体重、身高和体重指数,并分析其与健康人群根据年龄、性别和表型的差异。数据收集是在31年期间进行的纵向回顾性研究。通过先进的统计工具对z评分值进行统计分析。根据一般人群,PKU和轻度HPA个体的人体测量z评分的长期演变没有显著的统计学差异。对于PKU个体,其身高略低于健康人群,体重略高于健康人群,但差异小于一个标准差。然而,每种病理类型中女性身高z评分随时间的演变是不同的,在8至12岁之间出现交叉(p = 0.0186)。

结论

如今,通过适当的饮食治疗,PKU患者有可能实现长期正常生长。然而,PKU女性患者在8岁前生长加速,导致最终身高略低。通过使用非线性混合效应模型可以检测到这种行为。

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