Division of Nutrition and Metabolism, Istanbul Faculty of Medicine, Children's Hospital, Istanbul University, 34093 Istanbul, Turkey.
Nutrients. 2024 Oct 2;16(19):3355. doi: 10.3390/nu16193355.
BACKGROUND/OBJECTIVES: Phenylketonuria is a hereditary metabolic disorder characterized by a deficiency of phenylalanine hydroxylase. The main treatment for PKU is a phenylalanine-restricted diet. The exclusion of protein rich natural foods and inclusion of low-Phe substitutes may give rise to an imbalanced diet, and the increased risk of overweight and obesity in PKU is a cause for concern. We aimed to evaluate the body composition and nutritional biochemical biomarkers in adult PKU patients who are on Phe-restricted and essential amino acid-supplemented nutrition therapy and to investigate the relationships between these parameters and patient gender, adherence to dietary therapy, and disease type, defined as mild or classic PKU.
The study group comprised 37 PKU patients and 26 healthy siblings as controls. The participants were assessed based on an analysis of anthropometric parameters, body composition, and biochemical test results.
PKU patients do not have a higher incidence of overweight and obesity than healthy controls, the proportion of energy derived from carbohydrates in their diets was below the recommended level, and their total energy intake was below the recommended daily allowance. It was remarkable that patients with a treatment adherence ratio of <50% displayed a higher prevalence of overweight and abdominal obesity in comparison to those with a more favorable treatment adherence ratio.
In view of the growing prevalence of overweight in the general population, PKU patients should be kept under close long-term follow-up. Particularly in the group with low treatment compliance, more caution should be taken in terms of adverse outcomes.
背景/目的:苯丙酮尿症(PKU)是一种遗传性代谢疾病,其特征是苯丙氨酸羟化酶缺乏。PKU 的主要治疗方法是限制苯丙氨酸的饮食。排除富含蛋白质的天然食物和添加低苯丙氨酸替代品可能导致饮食不均衡,PKU 患者超重和肥胖的风险增加令人担忧。我们旨在评估接受限制苯丙氨酸和必需氨基酸补充营养治疗的成年 PKU 患者的身体成分和营养生化生物标志物,并研究这些参数与患者性别、饮食治疗依从性以及疾病类型(轻度或经典 PKU)之间的关系。
研究组包括 37 名 PKU 患者和 26 名健康兄弟姐妹作为对照。根据人体测量参数、身体成分和生化检测结果对参与者进行评估。
与健康对照组相比,PKU 患者的超重和肥胖发生率并不高,其饮食中碳水化合物提供的能量比例低于推荐水平,总能量摄入低于推荐日摄入量。值得注意的是,治疗依从性比值<50%的患者与治疗依从性比值较好的患者相比,超重和腹型肥胖的发生率更高。
鉴于超重在普通人群中日益流行,应密切长期随访 PKU 患者。特别是在治疗依从性较低的人群中,应更加注意不良后果。