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低蛋白产品供应对特定氨基酸代谢紊乱患者生长参数和代谢控制的影响。

The effects of low protein products availability on growth parameters and metabolic control in selected amino acid metabolism disorders patients.

作者信息

Handoom Bedour, Megdad Eman, Al-Qasabi Dana, Al Mesned Munirah, Hawary Reem, Al-Nufiee Samir, Al-Hassnan Zuhair, Alsayed Moeenaldeen Dia, Eldali Abdelmoneim

机构信息

Nutrition Department, King Faisal Specialist Hospital & Research Centre (KFSH&RC), Riyadh, SA, USA.

Medical Genetic Department, Children Hospital Taif, Taif, SA, USA.

出版信息

Int J Pediatr Adolesc Med. 2018 Jun;5(2):60-68. doi: 10.1016/j.ijpam.2018.04.001. Epub 2018 Jun 14.

Abstract

BACKGROUND

In Saudi Arabia, a diet for life policy has been adopted in the management of amino acid metabolism disorders for years. However, the specially designed low protein products/medical foods - which are one of the important treatment tools - were not available up until several years ago in Saudi Arabia (SA). Our aim was to measure the compliance and quality of life in patients affected with these disorders followed in the metabolic nutrition clinic at King Faisal Specialist Hospital & Research Centre (KFSH&RC), Riyadh, SA.

METHODOLOGY

We used a non-randomized retrospective/prospective study which utilized the growth parameters, biochemical data of patients plus questionnaires collected from patients and their family/caregivers. A total of n = 182 patients affected with selected amino acid metabolism disorders were enrolled. Some were excluded n = 84 for various reasons. Sample analyzed were: Phenylketonuria (PKU) (44), Maple Syrup Urine Disease (MSUD) (30), Tyrosinemia (TYR) (17) and Homocystinuria (HCU) (7). Tandem Mass Spectrometry (TMS) used to quantitate plasma amino acid concentrations. Data was obtained using (COMPLE) Microsoft-Access which was designed by the metabolic nutrition clinic at KFSH&RC-Riyadh. Student's paired -test was used to investigate relationship between variables.

RESULTS

The main findings were the improvement of selected amino acid levels pre and post the usage of medical foods. In PKU patients, the TMS Phenylalanine (PHE) levels post usage was significantly decreased ( value < .0001). This was also the case in MSUD patients with significant decrease in Leucine & Isoleucine levels ( value .0008) but not in Valine levels ( value .1148) as 36.7% of them received Valine supplements while enrolled in the study.

CONCLUSION

Low protein products availability was successful in improving outcomes for selected amino acid metabolic disorders. However, due to compliance issues and impracticality of the diet, the results were not significant in all enrolled patients.

摘要

背景

多年来,沙特阿拉伯在氨基酸代谢紊乱的管理中采用了“终身饮食”政策。然而,作为重要治疗手段之一的专门设计的低蛋白产品/医用食品,直到几年前在沙特阿拉伯(SA)都无法获得。我们的目的是评估在沙特阿拉伯利雅得法赫德国王专科医院及研究中心(KFSH&RC)代谢营养门诊接受治疗的这些疾病患者的依从性和生活质量。

方法

我们采用了一项非随机回顾性/前瞻性研究,利用患者的生长参数、生化数据以及从患者及其家人/护理人员收集的问卷。总共纳入了n = 182例患有特定氨基酸代谢紊乱的患者。由于各种原因,一些患者被排除在外(n = 84)。分析的样本包括:苯丙酮尿症(PKU)(44例)、枫糖尿症(MSUD)(30例)、酪氨酸血症(TYR)(17例)和高胱氨酸尿症(HCU)(7例)。采用串联质谱法(TMS)定量血浆氨基酸浓度。数据通过由利雅得KFSH&RC代谢营养门诊设计的(COMPLE)Microsoft-Access获得。使用学生配对检验来研究变量之间的关系。

结果

主要发现是医用食品使用前后特定氨基酸水平有所改善。在PKU患者中,使用后TMS苯丙氨酸(PHE)水平显著降低(值<0.0001)。MSUD患者的亮氨酸和异亮氨酸水平也显著降低(值0.0008),但缬氨酸水平未降低(值0.1148),因为其中36.7%的患者在研究期间接受了缬氨酸补充剂。

结论

低蛋白产品的供应成功改善了特定氨基酸代谢紊乱的治疗效果。然而,由于依从性问题和饮食的不实用性,并非所有纳入患者的结果都很显著。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6990/6363253/81d9eb89ad8b/gr1.jpg

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