Departamento de Gastroenterología y Nutrición Pediátrica, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
Departamento de Gastroenterología y Nutrición Pediátrica, Facultad de Medicina, Pontificia Universidad Católica de Chile, Hospital Josefina Martínez, Santiago, Chile.
Neurologia (Engl Ed). 2021 Mar;36(2):112-118. doi: 10.1016/j.nrl.2017.11.005. Epub 2018 Jan 17.
Children and adolescents with cerebral palsy (CP) are at a greater risk of malnutrition and micronutrient deficiencies. Two deficiencies that we can study and treat are vitaminD (VD) and iron deficiencies; however, no studies have described these deficiencies in Chile.
To describe the status of VD and iron in patients with CP and evaluate the relationship with certain factors associated with deficiencies of these micronutrients.
We performed a descriptive, cross-sectional study including 69 patients aged between 2 and 21years, from two public hospitals. Data were obtained on demographic variables, motor function, use of feeding tube, and pharmacological treatment. We performed a nutritional assessment according to patterns of CP and determined 25-hydroxyvitaminD (25[OH]D) ferritin, and albumin levels.
Patients' mean age was 11.1±4.9years; 43 (62.3%) were male; and 56 (81.2%) had moderate-to-severe CP. Thirty-five (50.7%) used a nasogastric tube and/or gastrostomy; 15.4% were underweight and 73.8% were eutrophic, all with normal height. Twenty (29%) and 4 patients (6.2%) received VD and iron supplementation, respectively. Albuminaemia was normal in all patients. Mean 25(OH)D level was 24.3±8.8ng/mL; 33 patients (47.8%) had insufficiency and 21 (30.4%) deficiency; 36 patients (52.2%) had low ferritin levels. There was no association between 25(OH)D level and the other variables studied. Low ferritin levels were found to be associated with older age (P=.03), being male (P=.006), and feeding tube use (P=.006).
The patients studied mainly had moderate-to-severe CP, with a high frequency of suboptimal VD values and low plasma ferritin; few patients received VD and/or iron supplementation. We suggest monitoring 25(OH)D and ferritin levels due to the high rate of deficiency of these nutrients; public hospitals should be equipped with drugs to treat these deficiencies.
脑瘫（CP）患儿存在更高的营养不良和微量营养素缺乏风险。我们可以研究和治疗的两种缺乏症是维生素 D（VD）和铁缺乏症；然而，智利尚未有研究描述这些缺乏症。
描述 CP 患儿的 VD 和铁状况，并评估这些微量营养素缺乏与某些相关因素的关系。
我们进行了一项描述性、横断面研究，纳入了来自两家公立医院的 69 名 2 至 21 岁的患者。收集人口统计学变量、运动功能、喂养管使用和药物治疗的数据。根据 CP 模式进行营养评估，并测定 25-羟维生素 D（25[OH]D）、铁蛋白和白蛋白水平。
患者的平均年龄为 11.1±4.9 岁；43 名（62.3%）为男性；56 名（81.2%）为中重度 CP。35 名（50.7%）使用鼻胃管和/或胃造口管；15.4%为体重不足，73.8%为营养良好，所有患者的身高均正常。20 名（29%）和 4 名（6.2%）患者分别接受了 VD 和铁补充治疗。所有患者的白蛋白血症正常。平均 25（OH）D 水平为 24.3±8.8ng/mL；33 名（47.8%）患者存在不足，21 名（30.4%）患者存在缺乏；36 名（52.2%）患者铁蛋白水平较低。25（OH）D 水平与研究的其他变量之间无相关性。较低的铁蛋白水平与年龄较大（P=.03）、男性（P=.006）和使用喂养管（P=.006）相关。
研究患者主要为中重度 CP，VD 值不足和血浆铁蛋白低的发生率较高；少数患者接受了 VD 和/或铁补充治疗。我们建议监测 25（OH）D 和铁蛋白水平，因为这些营养素缺乏的发生率较高；公立医院应配备治疗这些缺乏症的药物。
