Mehta Pooja, Furuta Glenn T, Brennan Taryn, Henry Michelle L, Maune Nancy Creskoff, Sundaram Shikha S, Menard-Katcher Calies, Atkins Dan, Takurukura Faith, Giffen Sandra, Pan Zhaoxing, Haas Angela M
Gastrointestinal Eosinophilic Diseases Program.
Digestive Health Institute.
J Pediatr Gastroenterol Nutr. 2018 Apr;66(4):603-608. doi: 10.1097/MPG.0000000000001741.
As both gastroesophageal reflux disease (GERD) and eosinophilic esophagitis (EoE) are associated with malnutrition and feeding dysfunction, this study compares growth, nutrition, and feeding behaviors in children with GERD and EoE.
Subjects ages 1 to 7 years with GERD or EoE were enrolled in a prospective study. Assessments included length/height, weight, 3-day food diary, serum biomarkers of nutrition, and the Behavioral Pediatric Feeding Assessment Scale.
Mean weight-for-length z scores in GERD and EoE children were -0.93 and -1.14 (p = NS) and mean body mass index z scores were 0.29 and -0.13 (P = NS). Vitamin D intake was below the daily recommended intake in GERD subjects. EoE subjects' intake was below daily recommended intake of Vitamin D and calcium. GERD and EoE groups both had normal intake of calories, carbohydrates, proteins, fats, and iron, and normal serum ferritin (25 vs 34 ng/mL), prealbumin (21 vs 20 mg/dL), parathyroid hormone (42 vs 37 pg/mL), and Vitamin D (both 30 ng/mL). Behavioral Pediatric Feeding Assessment Scale problem and frequency scores were similar in GERD and EoE subjects but were higher than those of a historical cohort of healthy controls (Hedges' g of 0.95 and 1.1, respectively). EoE subjects on food allergen restriction diets had significantly less feeding dysfunction than those on regular diets.
As a selected group of children with uncomplicated GERD or EoE were without nutritional deficiencies but had maladaptive feeding, providing anticipatory guidance to minimize mealtime challenges, monitoring for improvement, or referring to a feeding therapist, may be beneficial. A trial of food allergen restriction may provide additional benefit for those with EoE.
由于胃食管反流病（GERD）和嗜酸性粒细胞性食管炎（EoE）均与营养不良和喂养功能障碍相关，本研究比较了GERD和EoE患儿的生长、营养及喂养行为。
将1至7岁患有GERD或EoE的受试者纳入一项前瞻性研究。评估内容包括身长/身高、体重、3天食物日记、营养血清生物标志物以及儿童行为喂养评估量表。
GERD和EoE患儿的身长体重比Z评分均值分别为-0.93和-1.14（p=无显著性差异），体重指数Z评分均值分别为0.29和-0.13（P=无显著性差异）。GERD受试者的维生素D摄入量低于每日推荐摄入量。EoE受试者的维生素D和钙摄入量均低于每日推荐摄入量。GERD组和EoE组的热量、碳水化合物、蛋白质、脂肪和铁摄入量均正常，血清铁蛋白（25对34 ng/mL）、前白蛋白（21对20 mg/dL）、甲状旁腺激素（42对37 pg/mL）和维生素D（均为30 ng/mL）水平也正常。GERD和EoE受试者的儿童行为喂养评估量表问题及频率评分相似，但高于健康对照历史队列（效应量分别为0.95和1.1）。接受食物过敏原限制饮食的EoE受试者的喂养功能障碍明显少于接受常规饮食的受试者。
作为一组患有单纯性GERD或EoE的儿童，虽无营养缺乏，但存在适应不良的喂养行为，提供预期指导以尽量减少进餐挑战、监测改善情况或转诊至喂养治疗师可能有益。食物过敏原限制试验可能对EoE患者有额外益处。
