Pelizzo Gloria, Calcaterra Valeria, Carlini Veronica, Fusillo Mario, Manuelli Matteo, Klersy Catherine, Pasqua Noemi, Luka Elona, Albertini Riccardo, De Amici Mara, Cena Hellas
J Pediatr Endocrinol Metab. 2017 Mar 1;30(3):289-300. doi: 10.1515/jpem-2016-0369.
Malnutrition is reported in pediatric neuromotor disability and impacts the child's health. We described the nutritional and metabolic status in neurologically impaired (NI) children undergoing surgery.
Anthropometry, body composition, hormonal and nutritional evaluations were performed in 44 NI subjects (13.7±8.0 years). Energy needs were calculated by Krick's formula. Metabolic syndrome (MS) was defined applying the following criteria (≥3 defined MS): fasting blood glucose >100 mg/dL and/or homeostasis model assessment for insulin resistance (HOMA-IR) >97.5th percentile, trygliceride level >95th percentile, high-density lipoprotein (HDL)-cholesterol level <5th percentile, systolic/diastolic pressure >95th percentile; whilebody mass index - standard deviation score (BMI-SDS) <2 and biochemical malnutrition markers (≥2) defined undernutrition.
Energy intake was not adequate in 73.8% of the patients; no correlation between energy intake and BMI was noted. Undernutrition was noted in 34.1% of patients and MS in 11.36% of subjects. Fifty percent of the patients presented with insulin resistance, which was not related to BMI, body composition or other MS components.
Nutritional and metabolic monitoring of disabled children and young adults is recommended to prevent adverse outcomes associated with malnutrition.
据报道，小儿神经运动功能障碍患者存在营养不良情况，且会影响儿童健康。我们描述了接受手术的神经功能受损（NI）儿童的营养和代谢状况。
对44名NI受试者（13.7±8.0岁）进行了人体测量、身体成分分析、激素和营养评估。能量需求通过克里克公式计算。代谢综合征（MS）的定义采用以下标准（≥3项定义为MS）：空腹血糖>100mg/dL和/或胰岛素抵抗稳态模型评估（HOMA-IR）>第97.5百分位数，甘油三酯水平>第95百分位数，高密度脂蛋白（HDL）胆固醇水平<第5百分位数，收缩压/舒张压>第95百分位数；而体重指数-标准差评分（BMI-SDS）<2且生化营养不良标志物（≥2项）定义为营养不良。
73.8%的患者能量摄入不足；未发现能量摄入与BMI之间存在相关性。34.1%的患者存在营养不良，11.36%的受试者存在MS。50%的患者存在胰岛素抵抗，这与BMI、身体成分或其他MS成分无关。
建议对残疾儿童和青少年进行营养和代谢监测，以预防与营养不良相关的不良后果。
