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皮质激素疗法、营养及睡眠障碍对杜氏肌营养不良症患者生活质量的影响。

Impact of corticotherapy, nutrition, and sleep disorder on quality of life of patients with Duchenne muscular dystrophy.

作者信息

Jeronimo Giovanna, Nozoe Karen T, Polesel Daniel N, Moreira Gustavo A, Tufik Sergio, Andersen Monica L

机构信息

Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil.

Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil.

出版信息

Nutrition. 2016 Mar;32(3):391-3. doi: 10.1016/j.nut.2015.09.004. Epub 2015 Sep 30.

Abstract

Duchenne muscular dystrophy (DMD) is the second most common hereditary genetic disease in humans and has elevated mortality. DMD is an X-linked, life-limiting progressive muscle-wasting disease found predominantly in boys and young men. One of the main treatments for patients with DMD is corticosteroids. However, long-term use may cause major side effects such as obesity, a reduction in vitamin D, and osteoporosis. Sleep-disordered breathing is a common condition among patients with DMD, especially obstructive sleep apnea (OSA). In children, OSA is associated with obesity and a reduction of vitamin D concentration. In this article we aim to explore the interrelationship that exists between corticosteroids, obesity, OSA, and the risk of osteoporosis. Our main hypothesis is that factors such as nutrition and sleep are related to obesity and OSA, respectively. In addition, the chronic use of corticosteroids, obesity, and OSA are factors that can reduce serum levels of vitamin D, triggering osteoporosis. Thus, these factors play a key role in affecting the quality of life for patients with DMD and intervention based on these aspects may improve survival.

摘要

杜兴氏肌肉营养不良症(DMD)是人类第二常见的遗传性疾病,死亡率较高。DMD是一种X连锁的、危及生命的进行性肌肉萎缩疾病,主要发生在男孩和年轻男性身上。DMD患者的主要治疗方法之一是使用皮质类固醇。然而,长期使用可能会导致肥胖、维生素D减少和骨质疏松等主要副作用。睡眠呼吸障碍是DMD患者的常见病症,尤其是阻塞性睡眠呼吸暂停(OSA)。在儿童中,OSA与肥胖和维生素D浓度降低有关。在本文中,我们旨在探讨皮质类固醇、肥胖、OSA和骨质疏松风险之间存在的相互关系。我们的主要假设是,营养和睡眠等因素分别与肥胖和OSA有关。此外,长期使用皮质类固醇、肥胖和OSA是可降低血清维生素D水平、引发骨质疏松的因素。因此,这些因素在影响DMD患者生活质量方面起着关键作用,基于这些方面的干预可能会提高生存率。

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