Department of the Mother and Child Health, Pediatric Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
Department of Internal Medicine, University of Pavia, Pavia, Italy.
Horm Res Paediatr. 2017;88(3-4):224-230. doi: 10.1159/000477906. Epub 2017 Jul 10.
Allostatic load (AL) is the cumulative physiological wear and tear that results from repeated efforts to adapt to stressors over time. The life stress response is modified by nutritional status.
We estimated AL scores among neurologically impaired (NI) children; the association with malnutrition was also evaluated.
Forty-one patients with severe disabilities were included. Data based on 15 biomarkers were used to create the AL score. A dichotomous outcome of high AL was defined for those who had ≥6 dysregulated components. Body mass index (BMI)-standard deviation score (SDS) <-2 or SDS ≥2 and biochemical markers (≥4) defined malnutrition.
High AL was noted in 17/41 of the whole sample (41.47%). Malnutrition occurred in 36.6% of the subjects. A significant correlation between high AL and malnutrition was observed (p = 0.01; ar ea under the receiver operating characteristic curve, 0.7457). High AL subjects had a significantly higher BMI (p = 0.009) and lower BMI-SDS (p = 0.003) than low AL subjects. AL score correlated with fat mass (p ≤ 0.01) and negatively correlated with fat-free mass (p ≤ 0.02).
In NI children, high AL was associated with malnutrition. Body composition is a better indicator than BMI of allostatic adjustments. AL estimation should be considered a measure of health risk and be used to promote quality of life in at-risk disabled populations.
适应负荷（AL）是指随着时间的推移，为了适应压力源而反复努力所导致的累积生理损耗。营养状况会改变生活应激反应。
我们估计了神经损伤（NI）儿童的 AL 评分；还评估了其与营养不良的关系。
纳入 41 例严重残疾患者。使用基于 15 种生物标志物的数据来创建 AL 评分。将≥6 个失调成分的人定义为高 AL 组。体块指数（BMI）-标准差评分（SDS）<-2 或 SDS≥2 以及生化标志物（≥4）定义为营养不良。
整个样本中有 17/41（41.47%）的人存在高 AL。有 36.6%的受试者发生营养不良。高 AL 与营养不良之间存在显著相关性（p=0.01；接受者操作特征曲线下面积，0.7457）。高 AL 组的 BMI 显著高于低 AL 组（p=0.009），BMI-SDS 显著低于低 AL 组（p=0.003）。AL 评分与体脂（p≤0.01）相关，与去脂体重（p≤0.02）呈负相关。
在 NI 儿童中，高 AL 与营养不良有关。体成分是反映适应调整的一个比 BMI 更好的指标。AL 估计值应被视为健康风险的衡量标准，并用于提高高危残疾人群的生活质量。
