de Oliveira Marineia Porto, de Sousa Jorge Rodrigues, de Araujo Rafael Silva, de Sousa Aarão Tinara Leila, Quaresma Juarez Antonio Simões
Nucleo de Medicina Tropical, Universidade Federal do Para, Av. Generalissimo Deodoro 92, Umarizal, Belem, Para, 66055240, Brazil.
Centro de Ciencias Biologicas e da Saude, Universidade do Estado do Para, Belem, Para, Brazil.
Infect Dis Poverty. 2017 Sep 4;6(1):105. doi: 10.1186/s40249-017-0318-y.
Studies investigating the nutritional status of patients with leprosy and plantar ulcers are sparse. Therefore, the objective of this study was to describe the protein profile of leprosy patients with plantar ulcers from the Eastern Amazon region.
A case record form was created for 75 patients with leprosy (31 with plantar ulcers and 44 without plantar ulcers) with the following data: sociodemographic characteristics, clinical form of leprosy, presence or absence of plantar ulcers, and nutritional assessment using anthropometry consisting of the measurement of body mass index, arm circumference, arm muscle circumference, and triceps skinfold. Levels of blood albumin, transferrin, and C-reactive protein (CRP) were also measured. Data regarding protein intake were obtained using a Food Frequency Questionnaire.
Plantar ulcers occurred more frequently in male patients (67.7%), patients aged 40-49 years (mean ± SD: 47.3 ± 8.0 years), and patients receiving 300 or 600 USD (71.0%). The mean weight and height of patients were 71.6 ± 11.4 kg and 1.62 ± 0.1 m, respectively. High levels of CRP were detected in 51.6% of leprosy patients with plantar ulcers and only 9.1% of patients without plantar ulcers (P < 0.001). Nutritional depletion of transferrin was observed in 14.3% of patients with paucibacillary leprosy and 44.3% of patients with multibacillary leprosy (P = 0.0447). Most patients had normal levels of serum albumin (74.2% with plantar ulcers and 77.3% without plantar ulcers).
Most leprosy patients with plantar ulcers have normal levels of serum albumin and transferrin and high CRP levels, which indicates the presence of an inflammatory process. Our findings suggest the need to monitor patients with leprosy to prevent the occurrence of plantar ulcers and to provide adequate treatment for patients with existing plantar ulcers.
关于麻风病患者和足底溃疡患者营养状况的研究较少。因此，本研究的目的是描述来自亚马逊地区东部的患有足底溃疡的麻风病患者的蛋白质谱。
为75例麻风病患者（31例有足底溃疡，44例无足底溃疡）创建了一份病例记录表，记录以下数据：社会人口学特征、麻风病临床类型、有无足底溃疡，以及使用人体测量法进行营养评估，包括测量体重指数、上臂围、上臂肌肉围和三头肌皮褶厚度。还测量了血白蛋白、转铁蛋白和C反应蛋白（CRP）水平。使用食物频率问卷获取蛋白质摄入量数据。
足底溃疡在男性患者（67.7%）、40 - 49岁患者（平均±标准差：47.3±8.0岁）和收入300或600美元的患者（71.0%）中更常见。患者的平均体重和身高分别为71.6±11.4千克和1.62±0.1米。51.6%的患有足底溃疡的麻风病患者检测到高CRP水平，而无足底溃疡的患者中只有9.1%（P<0.001）。在少菌型麻风病患者中有14.3%观察到转铁蛋白营养缺乏，在多菌型麻风病患者中有44.3%（P = 0.0447）。大多数患者血清白蛋白水平正常（有足底溃疡的患者中74.2%，无足底溃疡的患者中77.3%）。
大多数患有足底溃疡的麻风病患者血清白蛋白和转铁蛋白水平正常，但CRP水平较高，这表明存在炎症过程。我们的研究结果表明需要对麻风病患者进行监测，以预防足底溃疡的发生，并为现有足底溃疡患者提供适当治疗。
