Pancreatic Exocrine Insufficiency Affects Not Only Digestibility of Nutrients and Growth, but Also Body Composition and Endocrinological Parameters- Study on Piglets Used As a Model for Children

A. Mösseler, T. Schwarzmaier, P. Gregory, M. Piechotta, M. Beyerbach, J. Kamphues
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引用次数: 5

Abstract

The pancreatic duct ligated (PL) piglet is a model for pancreatic exocrine insufficiency (PEI) in children. PEI is very common in children suffering from cystic fibrosis and is of highest relevance as the nutritional status affects survival rate of these patients. This study aimed comparing growth and body weight development of PL-piglets with (PL+enz) or without (PL-0) pancreatic enzyme replacement therapy (PERT) with those of controls. Growth, proportion of gastrointestinal tract (GIT; including digesta) and digestibility of nutrients was measured in young PL-pigs. The body weight (kg) at dissection differed significantly (p 0.05). PERT increased digestibility of fat and protein but reached no normalisation. Samples of ileal digesta taken during dissection indicated a significant reduction (p<0.005) in praecaecal starch digestibility in PL-0 (33.4%) compared to the controls (79.7%). This study demonstrates that PEI impaired growth, with improvement, but no complete normalisation, by PERT. The massive increase (p<0.0005) in GIT mass (21.1% of body weight in PL-0 compared to 8.17% in controls) is noteworthy, resulting in an overestimation of growth and nutritional condition in PL-0. Endocrinological parameters like leptin and IGF 1 were also impaired in the PL-pigs (p<0.05) and are supposed to be useful parameters to evaluate nutritional status in these PEI patients. As weight and BMI might result in an overestimation of nutritional status in PEI patients due to increased gut fill, there is need to implement further parameters to estimate nutritional status. Leptin seems to be a promising parameter to characterize nutritional status, even in juveniles – allowing an indirect quantification of the body fat content. Without need for any technical equipment on-site this parameter can be measured continuously during routine consultation, allowing an early detection of malnutrition and early therapeutic intervention.
胰腺外分泌不足不仅影响营养物质的消化率和生长,而且影响身体组成和内分泌参数——以仔猪为儿童模型的研究
胰管结扎(PL)仔猪是儿童胰腺外分泌功能不全(PEI)的模型。PEI在患有囊性纤维化的儿童中非常常见,其相关性最高,因为营养状况影响这些患者的生存率。本研究旨在比较(PL+enz)和(PL-0)胰腺酶替代治疗(PERT)与对照组的生长和体重发育。胃肠道生长比例(GIT;包括食糜)和营养物质消化率的测定。解剖时体重(kg)差异有统计学意义(p < 0.05)。PERT提高了脂肪和蛋白质的消化率,但没有达到正常水平。解剖过程中采集的回肠食糜样本显示,与对照组(79.7%)相比,PL-0的盲肠前淀粉消化率(33.4%)显著降低(p<0.005)。本研究表明PEI损害了PERT的生长,有改善,但没有完全正常化。值得注意的是,胃肠道质量的大幅增加(PL-0为体重的21.1%,对照组为8.17%)(p<0.0005),导致对PL-0生长和营养状况的高估。内分泌参数如瘦素和IGF - 1也在PEI猪中受损(p<0.05),被认为是评估这些PEI患者营养状况的有用参数。由于肠道填充增加,体重和BMI可能导致PEI患者营养状况的高估,因此需要实施进一步的参数来估计营养状况。瘦素似乎是表征营养状况的一个很有前途的参数,即使在青少年中也是如此——它允许对身体脂肪含量进行间接量化。无需现场任何技术设备,可在常规会诊期间连续测量该参数,从而实现营养不良的早期发现和早期治疗干预。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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