肠内营养对小儿克罗恩病患者体成分和骨密度的改善作用。
Improvement of body composition and bone mineral density after enteral nutrition in pediatric Crohn disease.
机构信息
Department of Woman, Child and General and Specialized Surgery, University of the Campania "Luigi Vanvitelli", Naples, Italy.
Department of Translational Medical Science, Section of Pediatrics, University of Naples "Federico II", Naples, Italy.
出版信息
Dig Liver Dis. 2020 Jun;52(6):630-636. doi: 10.1016/j.dld.2020.03.004. Epub 2020 Apr 6.
BACKGROUND
The relationship between exclusive enteral nutrition (EEN) and bone status is poorly defined in pediatric Crohn disease (CD).
AIMS
The aim of this study was to investigate the impact of EEN on body composition, nutritional status, and bone mineral density (BMD) in an incident CD cohort.
METHODS
18 newly diagnosed CD children starting EEN for 8 weeks were prospectively enrolled and evaluated at baseline and after 8 (T8), 26 (T26) and 52 weeks (T52) from diagnosis. The Fat Free Mass (FFM) and the Resting Energy Expenditure (REE) were measured through Bioelectrical Impedance (BIA) and the BMD was assessed by dual-energy X-ray (DXA). We compared DXA data of IBD patients to the data obtained in 15 healthy controls.
RESULTS
CD children had a significant lower BMD compared to healthy control both at baseline (p<0.0001), and after EEN therapy at T52 (p=0.0004); although at this latest time point CD children had a significant increase of BMD compared to baseline (p=0.0015). The BIA analysis showed a significant increase at T26 and T52 of FFM and REE. T52. FFM measured by BIA and BMD measured by DXA were significantly correlated.
CONCLUSION
EEN improves nutritional status and bone mineral composition.
背景
小儿克罗恩病（CD）中，肠内营养（EEN）与骨状态之间的关系尚未明确。
目的
本研究旨在探讨 EEN 对初诊 CD 患儿的身体成分、营养状况和骨密度（BMD）的影响。
方法
18 例新诊断为 CD 并开始 EEN 治疗的患儿前瞻性入组，分别在基线（诊断后 0 周，即 T0）、8 周（T8）、26 周（T26）和 52 周（T52）进行评估。通过生物电阻抗法（BIA）测量无脂肪质量（FFM）和静息能量消耗（REE），通过双能 X 线吸收法（DXA）评估 BMD。我们将 IBD 患者的 DXA 数据与 15 名健康对照者的数据进行了比较。
结果
与健康对照组相比，CD 患儿在基线时（p<0.0001）和 EEN 治疗后 52 周时（p=0.0004）的 BMD 均显著较低；尽管在最后一次随访时，CD 患儿的 BMD 与基线相比有显著增加（p=0.0015）。BIA 分析显示，FFM 和 REE 在 T26 和 T52 时显著增加。通过 BIA 测量的 T52 FFM 和通过 DXA 测量的 BMD 呈显著相关。
结论
EEN 可改善营养状况和骨矿物质组成。
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