Comprehensive analysis of nutritional parameters in patients with idiopathic achalasia: A prospective study in India.

IF 2 Q3 GASTROENTEROLOGY & HEPATOLOGY

Indian Journal of Gastroenterology Pub Date : 2025-02-01 Epub Date: 2024-08-19 DOI:10.1007/s12664-024-01664-5

Zaheer Nabi, Jahangeer Basha, Pradev Inavolu, Rajesh Goud, Vasudha Veligatla, Sai Priya Tummuru, Nandini Cheripelli, Madhulika Arutla, Mohan Ramchandani, Santhosh Darisetty, D Nageshwar Reddy

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引用次数: 0

Abstract

Background and aim: Achalasia cardia, a primary motility disorder of the esophagus, poses significant malnutrition risks. This study aims at comprehensively assessing the nutritional status in untreated achalasia patients, contrasting it with functional gastrointestinal disorders (FGIDs) cases and impact of per-oral endoscopic myotomy (POEM) on nutrition at one-year.

Methods: We conducted a prospective study, including consecutive achalasia cases, from December 2021 to April 2022 at a tertiary care centre. Biochemical parameters, anthropometry, subjective global assessment (SGA) and malnutrition universal screening tool were used for nutritional assessment. Cases diagnosed with FGIDs served as controls.

Results: As many as 118 cases (41.2 ± 13.9 years, 61% males) with achalasia and 200 controls (43.4 ± 11.9 years, 69% males) were included in the study. Sub-types of achalasia included type I (16.9%), II (76.3%) and III (6.8%). Overall, 38.1% and 6.8% cases were moderately and severely malnourished, respectively. As compared to controls, cases with achalasia had lower pre-albumin (19.4 vs. 25.2; p = 0.001), serum calcium (p = 0.012), vitamin D (p = 0.001), serum iron (p = 0.001), triceps fold thickness (p = 0.002) and hand-grip strength (p = 0.001). On univariate analysis, type-I achalasia, body mass index, % weight loss, lower esophageal sphincter pressures and Eckardt scores were predictors of malnourishment (SGA). On multivariate analysis, type of achalasia, mid arm circumference and low body mass index were significant predictors of malnourishment in cases with achalasia. There was significant improvement in the nutritional status after POEM at one-year follow-up.

Conclusion: Achalasia patients demonstrate a notably higher risk of malnutrition compared to individuals with FGIDs. Nutritional status significantly improves after POEM. (NCT05161923).

查看原文本刊更多论文

特发性贲门失弛缓症患者营养参数的综合分析：印度的一项前瞻性研究。

背景和目的：贲门失弛缓症是一种原发性食道运动障碍，存在严重的营养不良风险。本研究旨在全面评估未经治疗的贲门失弛缓症患者的营养状况，将其与功能性胃肠道疾病（FGIDs）病例进行对比，以及口腔内镜下肌切开术（POEM）对一年后营养状况的影响：我们于2021年12月至2022年4月在一家三级医疗中心开展了一项前瞻性研究，其中包括连续的贲门失弛缓症病例。生化指标、人体测量、主观全面评估（SGA）和营养不良通用筛查工具被用于营养评估。确诊为 FGIDs 的病例作为对照组：研究共纳入了 118 名贲门失弛缓症病例（41.2 ± 13.9 岁，61% 为男性）和 200 名对照组病例（43.4 ± 11.9 岁，69% 为男性）。贲门失弛缓症的亚型包括 I 型（16.9%）、II 型（76.3%）和 III 型（6.8%）。总体而言，38.1%和6.8%的病例分别患有中度和重度营养不良。与对照组相比，贲门失弛缓症病例的前白蛋白（19.4 对 25.2；P = 0.001）、血清钙（P = 0.012）、维生素 D（P = 0.001）、血清铁（P = 0.001）、肱三头肌褶皱厚度（P = 0.002）和手握力（P = 0.001）均较低。在单变量分析中，Ⅰ型贲门失弛缓症、体重指数、体重减轻百分比、下食道括约肌压力和 Eckardt 评分是营养不良（SGA）的预测因素。在多变量分析中，贲门失弛缓症类型、中臂围和低体重指数是贲门失弛缓症患者营养不良的重要预测因素。经过 POEM 一年的随访，患者的营养状况有了明显改善：结论：与 FGIDs 患者相比，贲门失弛缓症患者营养不良的风险明显更高。结论：与 FGIDs 患者相比，Achalasia 患者营养不良的风险明显更高。(NCT05161923）。

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来源期刊

Indian Journal of Gastroenterology GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

3.90

自引率

10.00%

发文量

期刊介绍： The Indian Journal of Gastroenterology aims to help doctors everywhere practise better medicine and to influence the debate on gastroenterology. To achieve these aims, we publish original scientific studies, state-of -the-art special articles, reports and papers commenting on the clinical, scientific and public health factors affecting aspects of gastroenterology. We shall be delighted to receive articles for publication in all of these categories and letters commenting on the contents of the Journal or on issues of interest to our readers.