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一大群患有科妮莉亚·德·朗格综合征谱系的意大利患者存在复杂的营养缺乏情况。

Complex nutritional deficiencies in a large cohort of Italian patients with Cornelia de Lange syndrome spectrum.

作者信息

Parma Barbara, Cianci Paola, Decimi Valentina, Mariani Milena, Provero Maria Cristina, Funari Caterina, Tajè Silvia, Apuril Erika, Cereda Anna, Panceri Roberto, Maitz Silvia, Fossati Chiara, Selicorni Angelo

机构信息

Department of Pediatrics, ASST-Lariana, Sant'Anna Hospital, San Fermo della Battaglia (Como), Italy.

Department of Pediatrics, San Gerardo Hospital, Monza, Italy.

出版信息

Am J Med Genet A. 2020 Sep;182(9):2094-2101. doi: 10.1002/ajmg.a.61749. Epub 2020 Jul 9.

Abstract

Cornelia de Lange syndrome Spectrum (CdLSp) is characterized by intellectual disability, facial dysmorphisms, and growth impairment. Although eating difficulties are a well-known feature of the disease, there is no data regarding the nutritional deficiencies of these patients. The food intake was tracked using a dietary transcription provided by the family/caregivers, biochemical nutritional parameters were measured with laboratory tests and through an accurate clinical evaluation of the incidence of qualitative and quantitative imbalances in a cohort of 73 patients with CdLSp ware determined. Of these 73, 62 (85%) subjects provided a complete and detailed dietary transcription. In the studied population, a quantitative caloric imbalance in 47/62 (76%) subjects was observed. The caloric intake was low in 27/62 (43%) subjects whereas excessive in 20/62 (33%). Only 15/62 (24%) had an optimum caloric intake. Regarding micronutrients, a calcium intake deficiency in 32% of the patients (20/62) was observed. Blood tests revealed a low iron level in 22/73 (30%) of the patients and 25(OH)D deficiency in 49/73 (67%). Serum hypocalcemia was not evidenced. Qualitative and quantitative imbalances resulted in more frequent than expected in CdLSp patients. A qualitative imbalance was more prevalent in younger patients while in older patients prevailed mainly a quantitative disproportion. We found no statistically meaningful correlation between dietary imbalances, genetic, or clinical parameters. Our findings highlight the need for further studies to evaluate the basal metabolic rate of CdLSp patients and find a correlation with their growth impairment.

摘要

科妮莉亚·德朗格综合征谱系(CdLSp)的特征为智力残疾、面部畸形和生长发育障碍。尽管进食困难是该疾病的一个众所周知的特征,但尚无关于这些患者营养缺乏情况的数据。通过家庭/照顾者提供的饮食记录来追踪食物摄入量,通过实验室检测测量生化营养参数,并通过对73例CdLSp患者队列中定性和定量失衡发生率进行准确的临床评估来确定营养情况。在这73例患者中,62例(85%)受试者提供了完整且详细的饮食记录。在研究人群中,观察到47/62(76%)受试者存在热量定量失衡。27/62(43%)受试者热量摄入低,而20/62(33%)受试者热量摄入过多。只有15/62(24%)的受试者热量摄入最佳。关于微量营养素,观察到32%的患者(20/62)存在钙摄入不足。血液检测显示22/73(30%)的患者铁水平低,49/73(67%)的患者存在25(OH)D缺乏。未发现血清低钙血症。定性和定量失衡在CdLSp患者中比预期更常见。定性失衡在年轻患者中更普遍,而在老年患者中主要是定量失衡。我们未发现饮食失衡、遗传或临床参数之间存在具有统计学意义的相关性。我们的研究结果强调需要进一步研究以评估CdLSp患者的基础代谢率,并找出其与生长发育障碍之间的相关性。

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