Unterman T G, Vazquez R M, Slas A J, Martyn P A, Phillips L S
Am J Med. 1985 Feb;78(2):228-34. doi: 10.1016/0002-9343(85)90431-0.
Malnutrition is common in hospitalized patients, but current measures of nutritional status are limited. Because levels of somatomedins are regulated by nutrition, the utility of somatomedin-C measurement in nutritional assessment was studied. Thirty-seven malnourished patients had measurement of somatomedin-C and conventional nutritional indexes. In 28 patients seen before therapy, the somatomedin-C level was reduced (38 percent of normal) and was lower than the albumin level (66 percent, p less than 0.01), transferrin level (59 percent, p less than 0.05), and lymphocyte count (43 percent, p = NS). Somatomedin-C level was lowest with combined "kwashiorkor-marasmus" (25 percent of normal) and also reduced with "kwashiorkor" (51 percent) or "marasmus" (57 percent) alone. Somatomedin-C was correlated with albumin, transferrin, and lymphocyte count (p less than 0.02 for each). In six patients given nutritional therapy, somatomedin-C levels rose by more than 70 percent in each (mean increase 181 percent), whereas lymphocyte counts rose in four (increase 78 percent for all patients), transferrin levels rose in four (increase 33 percent), and albumin levels rose in one (-6 percent). In 20 patients with detailed dietary analysis, only somatomedin-C was correlated with intake of protein and calories (p less than 0.005 for each). Somatomedin-C may be a sensitive marker of malnutrition and the response to nutritional therapy.
营养不良在住院患者中很常见，但目前的营养状况评估方法有限。由于生长调节素的水平受营养状况调节，因此对生长调节素-C检测在营养评估中的作用进行了研究。对37例营养不良患者检测了生长调节素-C和传统营养指标。在治疗前就诊的28例患者中，生长调节素-C水平降低（为正常水平的38%），且低于白蛋白水平（66%，p<0.01）、转铁蛋白水平（59%，p<0.05）和淋巴细胞计数（43%，p=无显著性差异）。生长调节素-C水平在“夸希奥科病-消瘦症”合并存在时最低（为正常水平的25%），单独出现“夸希奥科病”（51%）或“消瘦症”（57%）时也降低。生长调节素-C与白蛋白、转铁蛋白和淋巴细胞计数相关（每项p<0.02）。在6例接受营养治疗的患者中，每例患者的生长调节素-C水平均升高超过70%（平均升高181%），而淋巴细胞计数在4例患者中升高（所有患者升高78%），转铁蛋白水平在4例患者中升高（升高33%），白蛋白水平在1例患者中升高（-6%）。在20例进行详细饮食分析的患者中，只有生长调节素-C与蛋白质和热量摄入相关（每项p<0.005）。生长调节素-C可能是营养不良及对营养治疗反应的敏感指标。
