Glória L, Cravo M, Camilo M E, Resende M, Cardoso J N, Oliveira A G, Leitão C N, Mira F C
Serviço de Gastrenterologia, Instituto Português de Oncologia Francisco Gentil de Lisboa, Portugal.
Am J Gastroenterol. 1997 Mar;92(3):485-9.
Relationships of nutritional status with ethanol consumption and diet were studied in 33 chronic alcoholics with no clinical or laboratory evidence of liver disease.
Nutritional assessment included subjective global assessment, weight-height index, body mass index, and serum albumin measurements. Dietary intake included estimates of daily intake of substrates, folic acid, vitamins B1, B5, B6, and B12. Circulating concentrations of folate, pyridoxal-phosphate and vitamin B12 were evaluated as well.
Only 18.1% of patients were considered malnourished, with body mass indices lower than those with an average or good nutritional status (p < 0.0001). Body weight was under 90% of the ideal in 8/33 (24%) patients. Serum albumin values were within normal range in all patients. In terms of calories provided by nonalcoholic substrates, protein, or vitamin intake, we observed no differences between well and poorly nourished individuals. However, malnourished alcoholics consumed significantly more ethanol (p = 0.01) and an inverse correlation was found between ethanol intake and weight-height index (r = -0.35; p = 0.03). Low circulating concentrations of pyridoxal-phosphate and red blood cell folate were found in 51.5% and 60.6% of alcoholics, respectively. These were not correlated with vitamin dietary intake or ethanol consumption, but there was a trend toward malnourished patients to present lower concentrations of red blood cell folate (p = 0.13).
Although over malnutrition is infrequent in this group of chronic alcoholics, specific vitamin deficiencies are present in a substantial proportion of patients and are more likely related to alcohol consumption.
在33例无肝脏疾病临床或实验室证据的慢性酒精中毒患者中，研究营养状况与乙醇摄入量和饮食的关系。
营养评估包括主观全面评定、体重身高指数、体重指数和血清白蛋白测量。饮食摄入量包括对底物、叶酸、维生素B1、B5、B6和B12每日摄入量的估计。还评估了叶酸、磷酸吡哆醛和维生素B12的循环浓度。
只有18.1%的患者被认为营养不良，其体重指数低于营养状况平均或良好的患者（p<0.0001）。8/33（24%）的患者体重低于理想体重的90%。所有患者的血清白蛋白值均在正常范围内。就非酒精性底物、蛋白质或维生素摄入提供的热量而言，营养良好和营养不良的个体之间没有差异。然而，营养不良的酗酒者摄入的乙醇明显更多（p = 0.01），并且发现乙醇摄入量与体重身高指数呈负相关（r = -0.35；p = 0.03）。分别有51.5%和60.6%的酗酒者循环中的磷酸吡哆醛和红细胞叶酸浓度较低。这些与维生素饮食摄入量或乙醇消耗量无关，但营养不良患者的红细胞叶酸浓度有降低的趋势（p = 0.13）。
虽然这组慢性酗酒者中普遍营养不良的情况不常见，但相当一部分患者存在特定的维生素缺乏，且更可能与饮酒有关。
