Ohio State University, 453 West 10th Avenue, Columbus, OH, 43210, USA.
Ohio State University, 1841 Neil Ave., Columbus, OH, 43210, USA.
Dig Dis Sci. 2019 Aug;64(8):2318-2326. doi: 10.1007/s10620-019-05536-3. Epub 2019 Feb 23.
Chronic pancreatitis (CP) is a progressive, irreversible disease characterized by maldigestion and frequently accompanied by epigastric pain, exocrine insufficiency, and/or endocrine insufficiency. There is limited information about the dietary patterns in CP from which to guide medical nutrition therapy recommendations.
Study design was a cross-sectional, case-control study comparing subjects with CP (n = 52) to healthy controls (n = 48). Vioscreen™ food frequency questionnaire was used to assess the dietary pattern and nutrient intake in both groups. Dietary quality scores (the Healthy Eating Index, Mediterranean Diet score), and daily energy, macronutrient, and micronutrient intake levels were compared between groups.
Two sample t tests and Wilcoxon rank sum tests were used to evaluate differences in continuous variables, and Chi-squared tests were used for categorical variables.
CP was associated with a lower body mass index (BMI) (24 vs. 31 mg/kg; p < 0.001), lower HEI (57 vs. 65; p = 0.002), and aMED scores (29 vs. 32; p = 0.043) compared to healthy controls. Subjects with CP in the highest BMI quartile had the highest median aMED score compared to those in the lowest BMI quartile. There were no differences in kilocalories, macronutrients, or fat-soluble vitamin intake between groups, with the exception that vitamin K intake was lower in the CP group.
The overall quality of dietary intake is lower in subjects with CP compared to controls when assessed by two independent nutritional measurement tools. Further research is needed to examine contributing factors, such as food insecurity and coexisting endocrine or exocrine insufficiency, to dietary patterns in patients with CP from which to guide evidence-based recommendations for medical nutritional therapy.
慢性胰腺炎（CP）是一种进行性、不可逆的疾病，其特征为消化不良，并常伴有上腹痛、外分泌不足和/或内分泌不足。目前关于 CP 的饮食模式的信息有限，无法据此为医学营养治疗建议提供指导。
研究设计为一项比较 CP 患者（n=52）和健康对照者（n=48）的横断面病例对照研究。使用 Vioscreen™食物频率问卷评估两组的饮食模式和营养素摄入情况。比较两组的膳食质量评分（健康饮食指数、地中海饮食评分）以及每日能量、宏量营养素和微量营养素的摄入水平。
采用两样本 t 检验和 Wilcoxon 秩和检验比较两组间连续变量的差异，采用卡方检验比较两组间分类变量的差异。
与健康对照组相比，CP 患者的体质量指数（BMI）较低（24 与 31 mg/kg；p<0.001），HEI 评分较低（57 与 65；p=0.002），aMED 评分较低（29 与 32；p=0.043）。BMI 最高四分位数的 CP 患者的 aMED 评分中位数高于 BMI 最低四分位数的 CP 患者。两组间的热量、宏量营养素或脂溶性维生素的摄入量无差异，但 CP 组的维生素 K 摄入量较低。
使用两种独立的营养测量工具评估时，CP 患者的整体饮食摄入质量低于对照组。需要进一步研究以确定饮食模式的相关因素，如食物不安全和共存的外分泌或内分泌不足，从而为 CP 患者的医学营养治疗提供循证建议。
