俄罗斯北高加索地区各民族囊性纤维化患儿的营养状况特点

I. Sokolov, M. V. Simonov, O. Simonova, T. Borovik, T. Bushueva, V. Skvortsova, A. A. Pushkov, K. Savostyanov, A. Fisenko, T. Kazyukova, I.Yu. Matsneva, D.I. Mustafaeva, N. Kashirskaya
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引用次数: 0

摘要

囊性纤维化(CF)患者充足的营养状况与支气管肺系统的正常功能呈正相关。迄今为止,国内外已开展了许多研究来评估儿童和成人 CF 患者的营养状况。然而,目前还没有关于北高加索地区不同民族儿童因基因型不同而表现出的表型特征的数据。这项研究的目的是研究俄罗斯北高加索地区以下民族的 CF 儿童营养状况的特殊性:车臣人、卡拉恰伊-切尔克斯人、达吉斯坦人、印古什人和奥塞梯-阿兰人。采用的材料和方法:对北高加索各民族 117 名 2 个月至 17 岁(我 6 岁/o)的 CF 儿童进行了单中心开放式前瞻性研究。所有患者均接受了分子诊断以及营养状况和胰腺外分泌功能评估。结果显示俄罗斯北高加索地区 50.4% 的 CF 儿童患者存在 c.1545_1546delTA、p.(Tyr515*) 和 c.3846G>A、p.(Trp1282*) 的同源病理突变。这些突变在印古什族(100%)和车臣族(82%)中最常见,在达吉斯坦族(57.1%)和卡拉恰伊-切尔卡西亚族(54%)中则较少见。在车臣族和奥塞梯-阿兰族中,当检测到这些突变时,分别有 40.5% 和 100% 的病例确定为重症胰腺功能不全。在 60% 的病例中,假性巴特综合征是在患者出生后的最初几年中以同卵或复合杂合的形式被诊断出来的。与2021年俄罗斯全国CF患者登记册中正式记录的指标相比,不同民族CF患儿的营养状况指标明显偏低。结论:有必要分别研究不同人群的 CF 病程和营养状况,以及其与俄罗斯北高加索地区已确定的民族遗传特征之间的联系。这些患者的基因型和表型模式是胰腺外分泌功能紊乱和假性巴特综合征在幼年时发病的原因,而这反过来又会导致营养缺乏症的进一步发展。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
NUTRITIONAL STATUS PECULIARITIES IN CHILDREN WITH CYSTIC FIBROSIS OF THE RUSSIA’S NORTH CAUCASUS VARIOUS ETHNIC GROUPS
Adequate nutritional status in a patient with cystic fibrosis (CF) positively correlates with the normal function of the bronchopulmonary system. Many domestic and foreign studies have been conducted so far to assess the nutritional status of children and adults with CF. However, there is no data as yet on the phenotypic characteristics of children from different ethnic groups of the North Caucasus depending on their genotype. The purpose of this research was to study the peculiarities of nutritional status in children with CF of the following Russia’s North Caucasus ethnic groups: Chechen, Karachay-Circassian, Dagestani, Ingush and Ossetian-Alanian. Materials and methods used: a single-center open prospective study of 117 children with CF aged 2 months to 17 years old (Me 6 y/o) of various North Caucasus ethnic groups was conducted. All patients have undergone molecular diagnosis and assessment of both nutritional status and exocrine pancreatic function. Results: 50.4% of pediatric patients with CF in the Russia’s North Caucasus have had pathological mutations in c.1545_1546delTA, p.(Tyr515*) and c.3846G>A, p.(Trp1282*) in homozygous state. These mutations were most often found in the Ingush (100%) and Chechen (82%) ethnic groups and somewhat less frequently in the Dagestani (57.1%) and Karachay-Circassian (54%) ethnic groups. In the Chechen and Ossetian-Alanian ethnic groups, when these mutations were detected, severe pancreatic insufficiency was established in 40.5% and 100% of cases, respectively. Pseudo-Bartter syndrome was diagnosed in 60% of cases with this genetic variant in a homozygous or compound heterozygous states during the patients’ first years of life. Indicators for the nutritional status of children with CF from different ethnic groups were significantly lower compared to those recorded officially in the 2021 Russian National Register of Patients with CF. Conclusion: it is necessary to study the course of CF and the state of nutritional status separately in each population and its connection with the identified genetic characteristics of the Russia’s North Caucasus ethnic groups. The genotype and phenotype patterns for these patients were the reason for the development of disorders of the exocrine function of the pancreas and pseudo-Bartter syndrome at an early age, which in its turn could lead to further development of nutritional deficiency.
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