营养摄入对肢端肥大症患者骨质密度和骨质量的影响

IF 2.9 Q3 NUTRITION & DIETETICS

Clinical nutrition ESPEN Pub Date : 2025-03-26 DOI:10.1016/j.clnesp.2025.03.035

Natália Nachbar Hupalowski , Claudia Pinheiro Sanches Rocha , Vicente Florentino Castaldo , Cesar Luiz Boguszewski , Victoria Zeghbi Cochenski Borba

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引用次数: 0

摘要

背景与目的：在肢端肥大症患者中，营养在维持骨骼健康和生长激素（GH）和胰岛素样生长因子1 （IGF-1）的过度分泌中起着关键作用，这与破坏骨重塑和增加椎体骨折的风险有关。本研究的目的是评估肢端肥大症患者的饮食质量及其对骨密度、质量和骨折的影响。方法：这是一项横断面、观察性、对照研究，包括肢端肥大症（AG）患者和按性别和年龄匹配的对照组（CG）。通过食物频率问卷（FFQ）和饮食参考摄入量（DRIs）评估食物摄入量。采用双能x线骨密度仪（DXA）测量骨密度（BMD）和骨质量[骨小梁评分](TBS)，并通过问卷调查记录过去的骨折史。结果：共纳入82例，其中男性41例，女性58.5%，平均年龄55.9±11.8岁；平均体重指数（BMI）为31.14±5.16)，男性为41（58.5%为女性，56.8±14.3岁，平均BMI为25.5±3.3）。肢端肥大症的平均诊断年龄为43.7±13.0岁，63.4%的患者病情得到控制。在两组中，与DRIs相比，必需营养素（纤维、omega-3和6、维生素A和E）和矿物质（镁、钾和钙）的摄入量都不足。结论：肢端肥大症患者的骨质量较低，骨折发生率较高，尽管骨密度与抗氧化和抗炎化合物摄入不足有关，且摄入过多反式脂肪和低质量碳水化合物。

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Impact of nutrient intake on bone mineral density and bone quality in patients with acromegaly

Background & aims

Nutrition plays a critical role in maintaining bone health and excessive secretion of growth hormone (GH) and insulin-like growth factor 1 (IGF-1), in patients with acromegaly has been associated with disrupting bone remodeling and increased risk of vertebral fractures. The aim of this study was to assess the dietary quality of patients with acromegaly and its impact on bone density, quality and fractures.

Methods

This is a cross-sectional, observational, controlled study which included individuals with acromegaly (AG) and matched controls by sex and age (CG). Food intake was evaluated by a food frequency questionnaire (FFQ) and dietary reference intakes (DRIs). Bone mineral density (BMD) and bone quality [trabecular bone score] (TBS) measured by dual-energy X-ray absorptiometry (DXA) and the history of past fractures captured by a questionnaire.

Results

Eighty-two individuals were included, 41 in the AG (58.5 % women, mean age 55.9 ± 11.8 years; mean body mass index (BMI) 31.14 ± 5.16) and 41 in the CG (58.5 % women, 56.8 ± 14.3 years and mean BMI was 25.5 ± 3.3). The mean age at diagnosis of acromegaly was 43.7 ± 13.0 years and 63.4 % of AG had a controlled disease. In both groups, insufficient intake, compared to DRIs, of essential nutrients (fiber, omega-3 and 6, vitamins A and E) and minerals (magnesium, potassium, and calcium) was observed. Compared to the CG, the AG showed a higher intake of carbohydrates, trans fats, and certain micronutrients compared to the CG, p < 0.05 for all, similar BMD values, higher number of fractures (AG 0.63 ± 1.11 vs. CG 0.14 ± 0.43; p = 0.001) and poorer TBS (men AG 1.10 ± 0.43 vs. CG1.43 ± 0.09; p = 0.006; women AG 1.03 ± 0.54 vs. CG 1.35 ± 0.14; p = 0,009). In the AG fractures were negatively associated to flavones and vitamin A, and positively associated to IGF-1 levels (p < 0.05 for all). BMD and TBS were positively associated with different bioactive compounds (flavone, anthocyanin, beta-carotene and vitamin C), macronutrients and vitamins with anti-inflammatory activity.

Conclusion

individuals with acromegaly had low bone quality and higher prevalence of fractures despite adequate BMD associated to Inadequate intake of antioxidant and anti-inflammatory compounds, combined with excessive consumption of trans fats and poor-quality carbohydrate.

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来源期刊

Clinical nutrition ESPEN NUTRITION & DIETETICS-

CiteScore

4.90

自引率

3.30%

发文量

512

期刊介绍： Clinical Nutrition ESPEN is an electronic-only journal and is an official publication of the European Society for Clinical Nutrition and Metabolism (ESPEN). Nutrition and nutritional care have gained wide clinical and scientific interest during the past decades. The increasing knowledge of metabolic disturbances and nutritional assessment in chronic and acute diseases has stimulated rapid advances in design, development and clinical application of nutritional support. The aims of ESPEN are to encourage the rapid diffusion of knowledge and its application in the field of clinical nutrition and metabolism. Published bimonthly, Clinical Nutrition ESPEN focuses on publishing articles on the relationship between nutrition and disease in the setting of basic science and clinical practice. Clinical Nutrition ESPEN is available to all members of ESPEN and to all subscribers of Clinical Nutrition.