Evaluation of therapeutic education on intermittent fasting in patients with secondary adrenal insufficiency: A clinical trial

IF 3.2 3区医学 Q2 NUTRITION & DIETETICS

Nutrition Pub Date : 2025-01-14 DOI:10.1016/j.nut.2025.112688

Melika Chihaoui M.D., Mariam Mabrouk M.D., Ibtissem Oueslati M.D., Nadia Khessairi M.D., Fatma Chaker M.D., Meriem Yazidi M.D.

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引用次数: 0

Abstract

Objectives

Intermittent fasting was associated with complications in patients with adrenal insufficiency (AI). The study aimed to evaluate the impact of therapeutic education and drug adjustment on Ramadan fasting outcomes in patients with secondary AI (SAI).

Methods

A case-control prospective interventional study including patients with SAI willing to fast Ramadan 2023, and age-, gender-, and body mass index-matched healthy fasting controls. Before Ramadan, clinical examination, education for lifestyle measures, and hydrocortisone intake adjustment were performed. The occurrence of complications and the number of fasted days during Ramadan 2023 were reported and compared with those of Ramadan 2022 in patients and controls.

Results

A total of 50 patients; 33 women, median age: 43 years (34–55), median duration of SAI: 7.5 years (4–12.5), and 100 controls were enrolled, and fasted in 2023. Thirty-four patients and 100 controls fasted in 2022, corresponding to a 32% increase in fasting patients. Compared to 2022, there was a significant decrease in the frequency of complications in 2023 in patients compared to controls. The number of fasted days did not change. No severe event happened during the 2023 fasting. In patients, apart from the age that was higher in former fasters compared to new fasters, age, gender, body mass index, blood pressure levels, renal clearance, disease duration, and daily hydrocortisone dose were not associated with new versus former fasters, high versus low-risk patients, or incomplete versus complete month fasters.

Conclusions

Therapeutic education enabled more patients with SAI to fast and reduced the frequency of complications during fasting. Registered on “clinical trials.gov,” April 12, 2023, under the identifier ID: NCT05827965.

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对继发性肾上腺功能不全患者间歇性禁食治疗教育的评价：一项临床试验

目的：间断性禁食与肾上腺功能不全（AI）患者的并发症相关。本研究旨在评估治疗教育和药物调整对继发性AI （SAI）患者斋月禁食结局的影响。方法一项病例对照前瞻性干预性研究，纳入2023年斋月斋戒意愿的SAI患者，以及年龄、性别和体重指数匹配的健康禁食对照组。斋月前进行临床检查、生活方式教育、调整氢化可的松摄入量。报告2023年斋月期间的并发症发生情况和斋戒天数，并与2022年斋月期间的患者和对照组进行比较。结果共50例患者；纳入33名女性，中位年龄：43岁（34-55岁），SAI中位持续时间：7.5年（4-12.5年），100名对照组，并于2023年禁食。34名患者和100名对照组在2022年禁食，相当于禁食患者增加了32%。与2022年相比，与对照组相比，2023年患者并发症的频率显著降低。斋戒天数没有改变。2023年禁食期间没有发生严重事件。在患者中，除了先前禁食者的年龄高于新禁食者外，年龄、性别、体重指数、血压水平、肾脏清除率、疾病持续时间和每日氢化可的松剂量与新禁食者与先前禁食者、高风险患者与低风险患者、或不完全禁食者与完整禁食者无关。结论治疗性教育使更多的SAI患者禁食，减少了禁食期间并发症的发生。注册于“临床试验。gov”，2023年4月12日，识别码ID: NCT05827965。

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来源期刊

Nutrition 医学-营养学

CiteScore

7.80

自引率

2.30%

发文量

300

审稿时长

60 days

期刊介绍： Nutrition has an open access mirror journal Nutrition: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. Founded by Michael M. Meguid in the early 1980''s, Nutrition presents advances in nutrition research and science, informs its readers on new and advancing technologies and data in clinical nutrition practice, encourages the application of outcomes research and meta-analyses to problems in patient-related nutrition; and seeks to help clarify and set the research, policy and practice agenda for nutrition science to enhance human well-being in the years ahead.