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成人及老年人中口咽吞咽困难、营养状况、抗氧化维生素与炎症反应之间的关系:一项横断面研究。

Relationship between oropharyngeal dysphagia, nutritional status, antioxidant vitamins and the inflammatory response in adults and elderly: A cross-sectional study.

作者信息

Homem Suellen Guesser, Moreira Emilia Addison Machado, da Silva Alice Freitas, Barni Gabriela Cristofoli, da Rosa Julia Salvan, Oliveira Diane de Lima, Tomio Camila, de Freitas Maiara Brusco, Portari Guilherme Vannucchi, Furkim Ana Maria, Moreno Yara Maria Franco, Fröde Tânia Silvia

机构信息

Postgraduate Program in Nutrition, Federal University of Santa Catarina, Brazil.

Postgraduate Program in Pharmacy, Federal University of Santa Catarina, Brazil.

出版信息

Clin Nutr ESPEN. 2020 Aug;38:211-217. doi: 10.1016/j.clnesp.2020.04.011. Epub 2020 May 8.

Abstract

BACKGROUND & AIM: Oropharyngeal dysphagia (OD) can lead to a deficiency of antioxidant micronutrients. The aim of the present study was to investigate the relation between OD and nutritional status, antioxidant vitamins (β-carotene, vitamin E and C) and serum markers of the inflammatory response [C-reactive protein, myeloperoxidase (MPO), nitric oxide metabolites (NOx), tumor necrosis factor-α, interleukin (IL)-1β and IL-6] in adults and elderly.

METHODS

A cross-sectional study was conducted with 69 individuals: 22 in the control group (CG) and 47 in the OD group (ODG). The ODG was subdivided into ODG-mild = normal oral feeding (OF, n = 14), ODG-moderate (OF-modified, n = 22) and ODG-severe (OF-suspended, n = 11). Associations were investigated using multiple linear regression.

RESULTS

The body mass index (BMI) was higher in the ODG compared to the CG (p = 0.008), independently of sex, age, energy intake (EI) and score on the Functional Independence Measure. BMI was significantly lower in the ODG-severe compared to the ODG-mild (p = 0.012). OD was associated with lower concentrations of β-carotene (p < 0.001) and vitamin C (p < 0.001), independently of sex, age and EI, and higher concentrations of MPO (p = 0.008) and NOx (p = 0.011), independently of sex, age and the presence of comorbidities.

CONCLUSION

Adults and elderly with OD have lower levels of antioxidant vitamins (β-carotene and vitamin C) and a high inflammatory response (MPO and NOx). The evaluation of antioxidant vitamins could be incorporated in nutritional status assessment in this population.

摘要

背景与目的

口咽吞咽困难(OD)可导致抗氧化微量营养素缺乏。本研究旨在调查成人和老年人中OD与营养状况、抗氧化维生素(β-胡萝卜素、维生素E和C)以及炎症反应血清标志物[C反应蛋白、髓过氧化物酶(MPO)、一氧化氮代谢产物(NOx)、肿瘤坏死因子-α、白细胞介素(IL)-1β和IL-6]之间的关系。

方法

对69名个体进行了一项横断面研究:对照组(CG)22人,OD组(ODG)47人。ODG又分为ODG-轻度=正常经口喂养(OF,n = 14)、ODG-中度(OF-改良,n = 22)和ODG-重度(OF-暂停,n = 11)。采用多元线性回归研究相关性。

结果

与CG相比,ODG的体重指数(BMI)更高(p = 0.008),不受性别、年龄、能量摄入(EI)和功能独立性测量评分的影响。与ODG-轻度相比,ODG-重度的BMI显著更低(p = 0.012)。OD与较低的β-胡萝卜素浓度(p < 0.001)和维生素C浓度(p < 0.001)相关,不受性别、年龄和EI的影响,与较高的MPO浓度(p = 0.008)和NOx浓度(p = 0.011)相关,不受性别、年龄和合并症的影响。

结论

患有OD的成人和老年人抗氧化维生素(β-胡萝卜素和维生素C)水平较低,炎症反应较高(MPO和NOx)。抗氧化维生素的评估可纳入该人群的营养状况评估中。

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