Sands Dorota, Mielus Monika, Umławska Wioleta, Lipowicz Anna, Oralewska Beata, Walkowiak Jarosław
Cystic Fibrosis Centre Institute of Mother and Child, Kasprzaka Street 17A, 01-211 Warsaw, Poland, Telephone: (+48 22) 327-71-90, e-mail:
Dev Period Med. 2015 Jan-Mar;19(1):105-13.
Nutrition influence on cystic fibrosis (CF) patients survival is well documented and dietary therapy is one of basic elements of their treatment. Prolonged survival of CF patients might yet emerge comorbidities, which include bone mineral disease.
The assessment of the dietary pattern and its relationship between bone density in boys and girls with cystic fibrosis.
89 patients aged 10-18 years from 3 Polish CF Centres were included into the study. To obtain a knowledge about quality of diet, a 3-day food record was assessed and percent of recommended for CF patients intake of energy, protein, carbohydrates, fat, vitamin D3, calcium, phosphorus was counted. Bone mineral density (BMD) in lumbar spine (L1-L4) was measured and expressed as a Z-score. To assess nutritional status, anthropometric measurements was evaluated (body weight, height and BMI). Descriptive methods, Mann-Whitney test, T-Student test, Spearman correlation and one-way ANOVA were used for statistical analyses.
The patients with cystic fibrosis did not meet specific for CF nutritional guidelines. A deficiency in recommended intake was observed in energy (88%), protein (82%), calcium (78%) and vitamin D3 (71%). The intake of phosphorus was higher than recommended (142%). A nutritional status was significantly reduced, as compared with the reference group (p 0.001). Boys characterized significantly lower body weight (p=0.019) and height (p=0.036) than girls as well as worse caloric (p=0.023) and carbohydrates intake (p=0.005). However, girls had reduced vitamin D3 content in their diet (p 0.001). The bone mineral density in the whole group was reduced and Z-score amounted to -0.95 ± 1.17. Tendency to decreasing of BMD with age was observed. BMI showed important correlation with bone mineral density both in girls (p 0.001) and in boys (p=0.020).
CF patients do not follow specific for them dietary recommendations and essential differences were observed between girls and boys. Nutritional status (BMI) showed correlation with bone mineral density in CF patients. Therefore intensive nutritional therapy according to recommendations is needed. .
营养对囊性纤维化（CF）患者生存的影响已有充分记录，饮食疗法是其治疗的基本要素之一。CF患者的长期生存可能会出现包括骨矿物质疾病在内的合并症。
评估CF患儿的饮食模式及其与骨密度的关系。
本研究纳入了来自波兰3个CF中心的89例10 - 18岁患者。为了解饮食质量，评估了3天的食物记录，并计算了CF患者能量、蛋白质、碳水化合物、脂肪、维生素D3、钙、磷的推荐摄入量百分比。测量腰椎（L1 - L4）的骨矿物质密度（BMD）并表示为Z值。为评估营养状况，进行了人体测量（体重、身高和BMI）。采用描述性方法、曼 - 惠特尼检验、t检验、斯皮尔曼相关性分析和单因素方差分析进行统计分析。
CF患者未遵循针对CF的营养指南。能量（88%）、蛋白质（82%）、钙（78%）和维生素D3（71%）的推荐摄入量不足。磷的摄入量高于推荐量（142%）。与参照组相比，营养状况显著降低（p < 0.001）。男孩的体重（p = 0.019）和身高（p = 0.036）明显低于女孩，热量（p = 0.023）和碳水化合物摄入量（p = 0.005）也较差。然而，女孩饮食中的维生素D3含量降低（p < 0.001）。整个组的骨矿物质密度降低，Z值为 - 0.95 ± 1.17。观察到骨密度有随年龄降低的趋势。BMI在女孩（p < 0.001）和男孩（p = 0.020）中均与骨矿物质密度显示出重要相关性。
CF患者未遵循针对他们制定的饮食建议，且男孩和女孩之间存在显著差异。营养状况（BMI）与CF患者的骨矿物质密度相关。因此，需要根据建议进行强化营养治疗。
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