Department of Internal Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, Texas, USA.
Nutr Clin Pract. 2024 Oct;39(5):1102-1118. doi: 10.1002/ncp.11190. Epub 2024 Jul 14.
Patients with malabsorptive conditions can develop micronutrient deficiencies, even if they receive vitamins, minerals, or trace elements through their enteral or parenteral nutrition. Additionally, clinicians have faced challenges with micronutrient supplementation during parenteral product shortages and when transitioning patients from parenteral to enteral/oral nutrition. Evaluating micronutrient deficiencies through laboratory markers has various limitations, including that many are acute phase reactants, may not reflect storage status, or may not be readily available in clinical practice. Furthermore, clinicians can become overwhelmed with the variety of vitamin and mineral products available, the differences in dosages and ingredients in these products, and lastly, the inherent challenges associated with an impaired gastrointestinal tract. The current review will discuss some challenges clinicians may encounter in clinical practice during the evaluation, assessment, and prescription of micronutrient supplementation in patients with malabsorptive conditions.
患有吸收不良病症的患者即使通过肠内或肠外营养途径摄入维生素、矿物质或微量元素，也可能会出现微量营养素缺乏。此外，在肠外产品短缺和患者从肠外营养向肠内/口服营养过渡时，临床医生在进行微量营养素补充方面也面临挑战。通过实验室标志物评估微量营养素缺乏存在各种局限性，包括许多标志物是急性期反应物，可能无法反映储存状态，或者在临床实践中可能无法轻易获得。此外，临床医生可能会被各种可利用的维生素和矿物质产品、这些产品的剂量和成分差异，以及与受损的胃肠道相关的固有挑战所淹没。本综述将讨论临床医生在评估、评估和处方吸收不良病症患者的微量营养素补充时可能在临床实践中遇到的一些挑战。
