Ryan Jennifer J, Hanes Douglas A, Bradley Ryan D, Contractor Nikhat
Helfgott Research Institute, National University of Natural Medicine, Portland, Oregon.
Family Medicine and Public Health, University of California, San Diego, La Jolla, California.
Glob Adv Health Med. 2019 Jul 29;8:2164956119867251. doi: 10.1177/2164956119867251. eCollection 2019.
Due to the high prevalence of nutrient deficiencies in patients with inflammatory bowel disease (IBD), routine monitoring of nutrient status and supplementation are recommended.
This preliminary study was implemented to prospectively identify potential effects of a nutrition support formula on blood nutrient parameters in adults with IBD.
Ten adults with Crohn's disease or ulcerative colitis were recruited from the Portland, Oregon, metropolitan area into a single-arm, open-label pilot study. Participants consumed a nutrition support beverage twice daily for 12 weeks. The formula contained a mixture of micronutrients (including methylated forms of folate and vitamin B12), macronutrients, and phytonutrients (including curcumin, xanthohumol, ginger compounds, and quercetin). Primary measures were the following parameters: folate, vitamin B12, red blood cell (RBC) count, hemoglobin, hematocrit, electrolytes, and albumin. Exploratory measures included a food frequency questionnaire, circulating blood cell counts, and inflammatory markers.
Nine participants completed the study and one withdrew. Adherence was 98%. Serum folate increased 48.7% ( = .029), serum vitamin B12 increased 17.4% but did not reach statistical significance ( = .053), and red cell distribution width (RDW) decreased 9.2% ( = .012) over the 12-week study period. There were minimal shifts in total white blood cell (WBC) counts (-1.0%, = .845), but percent neutrophils decreased 10.4% ( = .042) and absolute lymphocyte count increased 18.6% ( = .048). RBC count, hemoglobin, hematocrit, electrolytes, albumin, and inflammatory markers did not change significantly. Post hoc analysis demonstrated that neutrophil-lymphocyte ratio (NLR) decreased 18.4% (not significant, = .061).
Serum folate and RDW improved in adults with IBD after 12 weeks. Modulation of leukocyte subtypes was also observed, including a decrease in neutrophils and an increase in lymphocytes, with no change in total WBC count. A randomized, controlled study to further examine effects of the nutrition support formula will be initiated to follow up on this promising, but preliminary investigation.
由于炎症性肠病(IBD)患者营养缺乏的发生率较高,建议对营养状况进行常规监测并进行补充。
本初步研究旨在前瞻性地确定营养支持配方对成年IBD患者血液营养参数的潜在影响。
从俄勒冈州波特兰市大都市区招募了10名患有克罗恩病或溃疡性结肠炎的成年人,进行单臂、开放标签的试点研究。参与者每天饮用两次营养支持饮料,持续12周。该配方包含微量营养素(包括叶酸和维生素B12的甲基化形式)、宏量营养素和植物营养素(包括姜黄素、黄腐酚、姜化合物和槲皮素)的混合物。主要测量指标为以下参数:叶酸、维生素B12、红细胞(RBC)计数、血红蛋白、血细胞比容、电解质和白蛋白。探索性测量指标包括食物频率问卷、循环血细胞计数和炎症标志物。
9名参与者完成了研究,1名退出。依从率为98%。在为期12周的研究期间,血清叶酸增加了48.7%(P = 0.029),血清维生素B12增加了17.4%,但未达到统计学显著性(P = 0.053),红细胞分布宽度(RDW)下降了9.2%(P = 0.012)。总白细胞(WBC)计数变化极小(-1.0%,P = 0.845),但中性粒细胞百分比下降了10.4%(P = 0.042),绝对淋巴细胞计数增加了18.6%(P = 0.048)。RBC计数、血红蛋白、血细胞比容、电解质、白蛋白和炎症标志物均无显著变化。事后分析表明,中性粒细胞-淋巴细胞比值(NLR)下降了18.4%(无显著性,P = 0.061)。
IBD成年患者在12周后血清叶酸和RDW有所改善。还观察到白细胞亚型的调节,包括中性粒细胞减少和淋巴细胞增加,而总WBC计数无变化。将启动一项随机对照研究,以进一步研究营养支持配方的效果,对这项有前景但初步的调查进行跟进。