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成人线粒体疾病患者的身体成分、身体机能和蛋白质摄入的关联。

Association of Body Composition, Physical Functioning, and Protein Intake in Adult Patients With Mitochondrial Diseases.

机构信息

Department of Gastroenterology and Hepatology-Dietetics, Radboudumc, Nijmegen, the Netherlands.

Department of Nutrition and dietetics, HAN University of Applied Sciences, Nijmegen, the Netherlands.

出版信息

JPEN J Parenter Enteral Nutr. 2021 Jan;45(1):165-174. doi: 10.1002/jpen.1826. Epub 2020 Mar 19.

Abstract

BACKGROUND

Whether decreased physical functioning of patients with mitochondrial disease (MD) is related to altered body composition or low protein intake needs clarification at the background of the nutrition state.

METHODS

In this 2-site cross-sectional study, MD patients were age-, body mass index (BMI)-, and gender-matched to controls. Body composition was assessed by dual-energy x-ray absorptiometry. Physical functioning was measured by handgrip strength, 6-minute walking test, 30-second sit-to-stand test (30SCT), and 6-minute mastication test. Total daily protein intake was calculated by 3-day food records. Malnutrition was assessed by Patient-Generated Subjective Global Assessment and the Global Leadership Initiative on Malnutrition (GLIM) criteria and sarcopenia by the 2018 consensus. Data were analyzed using independent samples t-tests, Fisher exact test, and Spearman and Pearson correlation coefficients.

RESULTS

Thirty-seven MD patients (42 ± 12 years, BMI: 23 ± 4 kg/m , 59% females) and 37 matched controls were included. Handgrip strength was moderate, inversely related to fat mass index in both MD patients and controls, whereas it correlated with fat-free mass index in controls solely. Protein intake was associated with muscle strength (handgrip strength and 30SCT) in MD patients but not in controls. Twenty-seven MD patients (73%) were malnourished, and 5 (14%) were classified as sarcopenic.

CONCLUSIONS

Muscle strength is related to body composition and protein intake in MD patients. This, in combination with the high incidence of both malnutrition and sarcopenia, warrants individual nutrition assessment in MD patients.

摘要

背景

在营养状况的背景下,需要阐明线粒体疾病(MD)患者身体功能下降是否与身体成分改变或蛋白质摄入低有关。

方法

在这项 2 个地点的横断面研究中,将 MD 患者与对照组按年龄、体重指数(BMI)和性别进行匹配。通过双能 X 射线吸收法评估身体成分。通过握力、6 分钟步行试验、30 秒坐站试验(30SCT)和 6 分钟咀嚼试验测量身体功能。通过 3 天的食物记录计算每日总蛋白质摄入量。通过患者生成的主观整体评估和全球营养不良倡议(GLIM)标准评估营养不良,通过 2018 年共识评估肌少症。使用独立样本 t 检验、Fisher 精确检验以及 Spearman 和 Pearson 相关系数分析数据。

结果

纳入 37 名 MD 患者(42±12 岁,BMI:23±4kg/m ,59%女性)和 37 名匹配的对照组。握力适中,与 MD 患者和对照组的脂肪量指数呈负相关,而仅与对照组的去脂体重指数相关。蛋白质摄入量与 MD 患者的肌肉力量(握力和 30SCT)相关,但与对照组无关。27 名 MD 患者(73%)存在营养不良,5 名(14%)被归类为肌少症。

结论

肌肉力量与 MD 患者的身体成分和蛋白质摄入量有关。这与营养不良和肌少症的高发生率相结合,需要对 MD 患者进行个体化营养评估。

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