Fiore P, Picco P, Castagnola E, Palmieri A, Levato L, Gremmo M, Tramalloni R, Cama A
Neurosurgery Department Pediatric Spinal Unit, Children's Hospital, Genoa, Italy.
Eur J Pediatr Surg. 1998 Dec;8 Suppl 1:34-6. doi: 10.1055/s-2008-1071250.
In patients affected by MMC both neurological and systemic dysfunctions may cause obesity and malnutrition. The aim of this study is a nutritional survey, with anthropometric assessment and dietary evaluation, of patients affected by MMC.
Anthropometric assessment, dietary evaluation, and a comprehensive assessment of motor impairment degree (MID) were performed in 100 patients (54 males, 46 females) affected by MMC aged from 6 to 228 months (median 91 months).
Fifty-five/100 children and adolescents with MMC were classified as normal or wellnourished and 5 at risk of malnutrition or malnourished, while another 40/100 patients were classified as marked overweight (weight-for-height or BMI above the 95th percentile). Deficit in height-for-age was observed in 34/100 patients; 12 of these patients presented with obesity. Dietary assessment evidenced that the majority of wellnourished patients (48/55) were consuming less than 80% or between 80% to 100% of recommended daily allowances (RDA) of energy. Overweight patients had an energy intake lower than their own RDA: 5 below 80%, 25 between 80% to 100%, and only 10 over 100% of RDA of energy for age and sex. No statistical correlation was found between nutritional status and MID, while there was a statistically significant difference between nutritional status and dietary intake (p = 0.005).
Overweight is the most frequent nutritional disease in patients affected by MMC. Since in our experience on correlation with MID was found, we can speculate that childhood and adolescent obesity in patients with MMC occurs as a result of complex interactive factors, not strictly related to energy intake and MID. Nutritional surveillance and specific treatment programs for overweight MMC patients are essential to enhance their quality of life.
在患有脊髓脊膜膨出（MMC）的患者中，神经功能和全身功能障碍均可能导致肥胖和营养不良。本研究的目的是对患有MMC的患者进行营养调查，包括人体测量评估和饮食评估。
对100例年龄在6至228个月（中位数91个月）的患有MMC的患者（54例男性，46例女性）进行了人体测量评估、饮食评估以及运动障碍程度（MID）的综合评估。
100例患有MMC的儿童和青少年中，55例被归类为正常或营养良好，5例有营养不良风险或营养不良，另外40例/100例患者被归类为明显超重（身高体重比或BMI高于第95百分位数）。100例患者中有34例出现年龄别身高不足；其中12例患者患有肥胖症。饮食评估表明，大多数营养良好的患者（48/55）摄入的能量低于推荐每日摄入量（RDA）的80%或在80%至100%之间。超重患者的能量摄入量低于其自身的RDA：5例低于80%，25例在80%至100%之间，只有10例超过年龄和性别的能量RDA的100%。营养状况与MID之间未发现统计学相关性，而营养状况与饮食摄入量之间存在统计学显著差异（p = 0.005）。
超重是患有MMC的患者中最常见的营养疾病。由于在我们的经验中未发现与MID的相关性，我们可以推测，MMC患者的儿童期和青少年肥胖是由复杂的相互作用因素导致的，并非严格与能量摄入和MID相关。对超重的MMC患者进行营养监测和特定的治疗方案对于提高他们的生活质量至关重要。
