生物电阻抗法与体重指数在杜氏肌营养不良患儿营养评估中的比较研究

赵晓鹏, 谢颖, 胡环宇, 赵丽华, 陈银红, 李增宁

中国儿童保健杂志 ›› 2020, Vol. 28 ›› Issue (8) : 917-920.

PDF(564 KB)
PDF(564 KB)
中国儿童保健杂志 ›› 2020, Vol. 28 ›› Issue (8) : 917-920. DOI: 10.11852/zgetbjzz2019-1513
临床研究与分析

生物电阻抗法与体重指数在杜氏肌营养不良患儿营养评估中的比较研究

  • 赵晓鹏, 谢颖, 胡环宇, 赵丽华, 陈银红, 李增宁
作者信息 +

Comparative study on bioelectrical impedance analysis and body mass indexin nutrition assessment of children with duchenne muscular dystrophy

  • ZHAO Xiao-peng, XIE Ying, HU Huan-yu, ZHAO Li-hua, CHEN Yin-hong, LI Zeng-ning
Author information +
文章历史 +

摘要

目的 应用生物电阻抗分析(BIA)检测杜氏肌营养不良(DMD)患儿体成分, 并比较体重指数(BMI)与体脂百分比(PBF)判定患儿超重的一致性。方法 收集2015年8月-2017年2月在河北医科大学第三医院神经肌肉病科就诊的39例男性DMD患者作为患儿组, 同期随机选取46例健康男童作为对照组。应用BIA对两组儿童进行人体成分检测。结果 两组儿童的脂肪含量、BMI差异均无统计学意义(P>0.05)。患儿组的身高、体重、身体水分、蛋白质、无机盐、肌肉质量和基础代谢率(BMR)均低于对照组(P<0.05), 但患儿组的PBF高于对照组(P<0.05)。患儿组中PBF与年龄呈正相关关系(r=0.546, P<0.05), BMI与PBF在判定DMD患儿超重时的一致性较差(Kappa=0.352, P<0.05)。结论 相比于同年龄段同性别的健康少儿, DMD患儿的整体营养状况较差, 应用BIA比使用BMI能更加准确地评估患儿的营养状况。

Abstract

Objective To analyze the body composition of children with duchenne muscular dystrophy (DMD) by bioelectrical impedance analysis (BIA), and to compare the consistency of body mass index (BMI) with the percentage of body fat (PBF) when assessing the overweight of DMD children. Methods A total of 39 male DMD children were enrolled in case group from August 2015 to February 2017 in Neuromuscular Department of the Third Hospital of Hebei Medical University, and 46 healthy boys were randomly selected as control group during the same period.BIA was used to test body composition in two groups. Results There was no significant difference on fat content and BMI between the two groups (P>0.05).The height, weight, body water, protein, inorganic salt, muscle mass and basal metabolic rate (BMR) of DMD children were significantly lower than those in control group (P<0.05).However, the PBF of DMD children was higher than that of the control group (P<0.05).There was positive correlation between PBF and age in DMD children (r=0.546, P<0.05).BMI was poorly consistent with PBF in determining the overweight of children with DMD (Kappa=0.352, P<0.05). Conclusions Compared with healthy children with the same age and gender, the nutritional status of DMD children is poor.BIA can more accurately assess the nutritional status of patients than using BMI.

关键词

杜氏肌营养不良 / 生物电阻抗分析 / 体脂百分比

Key words

duchenne muscular dystrophy / bioelectrical impedance analysis / percentage of body fat

引用本文

导出引用
赵晓鹏, 谢颖, 胡环宇, 赵丽华, 陈银红, 李增宁. 生物电阻抗法与体重指数在杜氏肌营养不良患儿营养评估中的比较研究[J]. 中国儿童保健杂志. 2020, 28(8): 917-920 https://doi.org/10.11852/zgetbjzz2019-1513
ZHAO Xiao-peng, XIE Ying, HU Huan-yu, ZHAO Li-hua, CHEN Yin-hong, LI Zeng-ning. Comparative study on bioelectrical impedance analysis and body mass indexin nutrition assessment of children with duchenne muscular dystrophy[J]. Chinese Journal of Child Health Care. 2020, 28(8): 917-920 https://doi.org/10.11852/zgetbjzz2019-1513
中图分类号: :R746.2   

参考文献

[1] Birnkrant DJ, Bushby K, Bann CM, et al.Diagnosis and management of Duchenne muscular dystrophy, part1: diagnosis, and neuromuscular, rehabilitation, endocrine, and gastrointestinal and nutritional management[J].Lancet Neurol, 2018, 17(3):251-267.
[2] Rodríguez-Cruz M, Sanchez R, Escobar RE, et al.Evidence of insulin resistance and other metabolic alteration in boys with Duchenne or Becker muscular dystrophy[J].Int J Endocrinol, 2015, 2015:1-8.
[3] David RW, Stasia H, Hugh JM, et al.Obesity and Endocrine Management of the patient with Duchenne muscular dystrophy[J].Pediatrics, 2018, 142(Suppl 2):43-52.
[4] Haddad L, Achadi E, Bendech MA, et al.The global nutrition report 2014: actions and accountability to accelerate the world's progress on nutrition[J].J Nutr, 2015, 145(4):663-671.
[5] Barja S, Perez R.Clinical assessment underestimates fat mass and overestimates resting energy expenditure in children with neuromuscular diseases[J].Clin Nutr ESPEN, 2016, 15:11-15.
[6] Elliott SA, Davidson ZE, Davies PS, et al.A bedside measure of body composition in Duchenne muscular dystrophy[J].Pediatr Neurol, 2015, 52(1):82-87.
[7] 李辉, 季成叶, 宗心南, 等.中国0~18岁儿童、青少年体块指数的生长曲线[J].中华儿科杂志, 2009, 47(7):493-498.
[8] Deurenberg P, Deurenberg YM, Staveren WA.Body mass index and percent body fat: A meta-analysis among different ethnic groups[J].Int J Obes Relat Metab Disord, 1998, 22(12):1164-1171.
[9] Lamb MM, West NA, Ouyang L, et al.Corticosteroid treatment and growth patterns in ambulatory in males with Duchenne muscular dystrophy[J].J Pediatr, 2016, 173:207-213.
[10] Crabtree NJ, Adams JE, Padidela R, et al.Growth, bone health & ambulatory status of boys with DMD treated with daily vs intermittent oral glucocorticoid regimen[J].Bone, 2018, 116:181-186.

[11] Barzegar M, Niknam E, Habibi P, et al.Bone mineral density and bone metabolism in patients with duchenne muscular dystrophy[J].Iran J Child Neurol, 2018, 12(1):77-83.
[12] DelRocio Cruz-Guzman O, Rodriguez-Cruz M, Almeida-Bec erril T, et al.Muscle function and age are associated with loss of bone mineral density in Duchenne muscular dystrophy[J].Muscle Nerve, 2019, 54(9):417-421.
[13] Bernabe-Garcia M, Rodriguez-Cruz M, Atilano S, et al.Body composition and body mass index in Duchenne muscular dystrophy: Role of dietary intake[J].Muscle Nerve, 2019, 59(3):295-302.
[14] Davis J, Samuels E, Mullins L.Nutrition considerations inDuchenne muscular dystrophy[J].Nutr Clin Pract, 2015, 30(4):511-521.
[15] Yiu EM, Kornberg AJ.Duchenne muscular dystrophy[J].J Paediatr Child Health, 2015, 51(8):759-764.
[16] Saure C, Caminiti C, Weglinski J, et al.Energy expenditure, body composition, and prevalence of metabolic disorders in patients with Duchenne muscular dystrophy[J].Diabetes Metab Syndr, 2018, 12(2):81-85.
[17] 张慧云, 李燕, 刘长云, 等.济南市4~6岁儿童体成分分析[J].中国儿童保健杂志, 2019, 27(05):554-557.
[18] Pessolano FA, Súarez AA, Monteiro SG, et al.Nutritional assessment of patients with neuromuscular diseases[J].Am J Phys Med Rehabil, 2003, 82(3):182-185.
[19] Mok E, Beghin L, Gachon P, et al.Estimating body composition in children with Duchenne muscular dystrophy:comparison of bioelectrical impedance analysis and skinfold-thickness measurement[J].Am J Clin Nutr, 2006, 83(1):65-69.
[20] Davidson ZE, Ryan MM, Kornberg AJ, et al.Observations of body mass index in Duchenne muscualr dystrophy: a longitudinal study[J].Eur J Clin Nutr, 2014, 68(8):892-897.
[21] Kyle UG, Bosaeus I, De Lorenzo AD, et al.Bioelectrical impedance analysis dpart II: utilization in clinical practic[J].Clin Nutr, 2004, 23(6):1430-1453.
[22] Barbosa-Silva MC, Barros AJ.Bioelectrical impedance analysis in clinical practice: a new perspective on its use beyond body composition equations[J].Curr Opin Clin Nutr Metab Care, 2005, 8(3):311-317.

基金

2018年度省医学适用技术跟踪项目(G2018021)

PDF(564 KB)

Accesses

Citation

Detail

段落导航
相关文章

/