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1 Asia Pacific Journal of Clinical Nutrition
       Volume 24, 1

         (March 2015)


Abstracts

Contents

Abstract PDF

Asia Pacific Clinical Nutrition Society Award for 2015: Luca Tommaso Cavalli-Sforza

Duo Li

Asia Pac J Clin Nutr. 2015;24(1):i.

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Reviews

Public Health & Nutrition in the Asia-Pacific: reflections on a quarter century
LUCA TOMMASO CAVALLI-SFORZA
Asia Pac J Clin Nutr. 2015;24(1):1-19.

doi: 10.6133/apjcn.2015.24.1.23

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Omega-3 polyunsaturated fatty acids and non-communicable diseases: meta-analysis based systematic review
DUO LI

Asia Pac J Clin Nutr. 2015;24(1):10-15.

doi: 10.6133/apjcn.2015.24.1.21

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Feeding practices among Indonesian children above six months of age: a literature review on their magnitude and quality (part 1)
SONIA BLANEY, JUDHIASTUTY FEBRUHARTANTY AND SRI SUKOTJO

Asia Pac J Clin Nutr. 2015;24(1):16-27.

doi: 10.6133/apjcn.2015.24.1.13

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Feeding practices among Indonesian children above six months of age: a literature review on their potential determinants (part 2)
SONIA BLANEY, JUDHIASTUTY FEBRUHARTANTY AND SRI SUKOTJO

Asia Pac J Clin Nutr. 2015;24(1):28-37.

doi: 10.6133/apjcn.2015.24.1.14

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Original Research Communications

Clinical Nutrition or Feeding Studies

 

Early enteral nutrition for upper digestive tract malformation in neonates
WEIWEI JIANG, XIAOFENG LV, XIAOQUN XU, QIMING GENG, JIE ZHANG AND WEIBING TANG
Asia Pac J Clin Nutr. 2015;24(1):38-43.

doi: 10.6133/apjcn.2015.24.1.08

 

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Comparison of a three-in-one total nutrient mixture with conventional peripheral parenteral nutrition in children
DAE YONG YI AND HYE RAN YANG
Asia Pac J Clin Nutr. 2015;24(1):44-50
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doi: 10.6133/apjcn.2015.24.1.07

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Early jejunal feeding by bedside placement of a nasointestinal tube significantly improves nutritional status and reduces complications in critically ill patients versus enteral nutrition by a nasogastric tube
BING WAN, HAIYAN FU AND JIANGTAO YIN
Asia Pac J Clin Nutr. 2015;24(1):51-57.

doi: 10.6133/apjcn.2015.24.1.03

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Impacts of dietary fat changes on pregnant women with gestational diabetes mellitus: a randomized controlled study
HUIYAN WANG, HONGYI JIANG, LIPING YANG AND MING ZHANG
Asia Pac J Clin Nutr. 2015;24(1):58-64.

doi: 10.6133/apjcn.2015.24.1.19

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BMI status influences the response of insulin sensitivity to diacylglycerol oil in Chinese type 2 diabetic patients
JU-SHENG ZHENG, LING WANG, MEI LIN, HONG YANG AND DUO LI
Asia Pac J Clin Nutr. 2015;24(1):65-72.

doi: 10.6133/apjcn.2015.24.1.01

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Dietary modifications to improve micronutrient status of Indian children and adolescents with type 1 diabetes
LAVANYA S PARTHASARATHY, SHASHI A CHIPLONKAR, ANURADHA V KHADILKAR AND VAMAN V KHADILKAR
Asia Pac J Clin Nutr. 2015;24(1):73-82.

doi: 10.6133/apjcn.2015.24.1.04

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Nutritional Status, Dietary Intake, and Body Composition

 

Associations of decreased serum transthyretin with elevated high-sensitivity CRP, serum copper and decreased hemoglobin in ambulatory elderly women
AYAKA TSUBOI, MAYU TERAZAWA-WATANABE, TSUTOMU KAZUMI AND KEISUKE FUKUO

Asia Pac J Clin Nutr. 2015;24(1):83-89.

doi: 10.6133/apjcn.2015.24.1.18

 

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Dairy consumption and risk of cardiovascular disease: an updated meta-analysis of prospective cohort studies
LI-QIANG QIN, JIA-YING XU, SHU-FEN HAN, ZENG-LI ZHANG, YOU-YOU ZHAO AND IGNATIUS MY SZETO
Asia Pac J Clin Nutr. 2015;24(1):90-100
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doi: 10.6133/apjcn.2015.24.1.09

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Intake of cruciferous vegetables is associated with reduced risk of ovarian cancer: a meta-analysis
JIYI HU, YIWANG HU, YETING HU AND SHU ZHENG
Asia Pac J Clin Nutr. 2015;24(1):101-109.

doi: 10.6133/apjcn.2015.24.1.22

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Change in weight status and academic performance among senior high school students in Taiwan
PEI-AN LIAO, HUNG-HAO CHANG, JIUN-HAO WANG AND MIN-CHEN WU
Asia Pac J Clin Nutr. 2015;24(1):110-117.
doi: 10.6133/apjcn.2015.24.1.02

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Weight-related stigmatization and binge eating among overweight adults in Southern Taiwan
YA-KE WU AND YI LIU
Asia Pac J Clin Nutr. 2015;24(1):118-127.
doi: 10.6133/apjcn.2015.24.1.05

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Maternal and Clild Nutrition

Circulating IGF-1 may mediate improvements in haemoglobin associated with vitamin A status during pregnancy in rural Nepalese women
MARGIA A ARGUELLO, KERRY J SCHULZE, LEE SF WU, MICHELE L DREYFUSS, SUBARNA K KHATRY, PARUL CHRISTIAN AND KEITH P WEST
Asia Pac J Clin Nutr. 2015;24(1):128-137.

doi: 10.6133/apjcn.2015.24.1.12

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Maternal serum lipid levels during late pregnancy and neonatal body size
KUI YE, QING-LI BO, QIU-JU DU, DAN ZHANG, YING SHEN, YAN-PING HAN, YUAN-BI LI, YI LI, CHUAN-LAI HU AND LI LI

Asia Pac J Clin Nutr. 2015;24(1):138-143.

doi:10.6133/apjcn.2015.24.1.20

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Micronutrient status and its relationship with nutritional status in preschool children in urban Sri Lanka
ESHANI MARASINGHE, SUREKA CHACKREWARTHY, CHRISHANTHA ABEYSENA AND SHAMAN RAJINDRAJITH

Asia Pac J Clin Nutr. 2015;24(1):144-151.

doi: 10.6133/apjcn.2015.24.1.17

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Locally produced cereal/nut/legume-based biscuits versus peanut/milk-based spread for treatment of moderately to mildly wasted children in daily programmes on Nias Island, Indonesia: an issue of acceptance and compliance?
VERONIKA SCHERBAUM, RATNA CHRISMIARI PURWESTRI, WOLFGANG STUETZ, DYAH AYU INAYATI, JULIA SURYANTAN, MAURICE ALEXANDER BLOEM AND HANS KONRAD BIESALSKI
Asia Pac J Clin Nutr. 2015;24(1):152-161.

doi: 10.6133/apjcn.2015.24.1.15

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Nutritional Epidemiology and Public Health

 

Factors associated with not using antenatal iron/folic acid supplements in Indonesia: the 2002/2003 and 2007 Indonesia Demographic and Health Survey
CHRISTIANA RIALINE TITALEY AND MICHAEL JOHN DIBLEY
Asia Pac J Clin Nutr. 2015;24(1):162-176.

doi: 10.6133/apjcn.2015.24.1.10

 

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Trying to lose weight among non-overweight university students from 22 low, middle and emerging economy countries
KARL PELTZER AND SUPA PENGPID

Asia Pac J Clin Nutr. 2015;24(1):177-183.

doi: 10.6133/apjcn.2015.24.1.16

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Case Study

Effects of different parenteral nutrition infusions in a patient with short bowel syndrome
CHIA-CHEE WENG AND YUN CHEN
Asia Pac J Clin Nutr. 2015;24(1):184-187.

doi: 10.6133/apjcn.2015.24.1.06

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Book Review

Climate Change and Global Health
MARK L WAHLQVIS
Asia Pac J Clin Nutr. 2015;24(1):188.

 

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Future Events

Asia Pac J Clin Nutr. 2015;24(1):189.

 

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Public Health & Nutrition in the Asia-Pacific: reflections on a quarter century
LUCA TOMMASO CAVALLI-SFORZA
Some reflections from work in the Asia Pacific Region, mostly with WHO, in the past 25 years, and the changes in nutrition seen in this time are shared. In 1988-89 I helped to start a Centre for Child Nutrition in Chengdu, Si-chuan, through the Italian Development Cooperation. The nutritional problems in urban and rural China, 25 years ago, were similar to those elsewhere in the Region. Like China, these countries underwent rapid economic development and changes in health patterns, within two decades. The main problems for child nutrition had to do with infant feeding practices and less breastfeeding: anaemia, protein energy malnutrition and rickets were fre-quent. How did China and other countries tackle these and other nutrition problems? In the 1990s the global nu-trition community started working on a problem-solving framework. In 1992, at the 1st FAO/WHO International Conference on Nutrition, 159 countries agreed to develop national nutrition plans. In 2014, 22 years later, FAO and WHO invited countries to review their national nutrition situation and plans. The epidemiological picture to-day is profoundly different. Many Asia-Pacific countries have achieved remarkable progress in socio-economic development, including malnutrition reduction. To reach the MDGs and the post-MDG goals being formulated, the remaining under-nutrition problems need to be alleviated, inequalities between sectors of society reduced, and also the growing threat of overweight/obesity and NCDs prevented and controlled. Assessing, monitoring and evaluating programmes to improve progress, now requires focusing not only on biological outcomes, but al-so on food security, programme process, and the policy environment.
Key Words: review, nutrition, Asia-Pacific, 25 years
 

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亚太地区的公共卫生与营养:四分之一个世纪的回顧
本文提供了一个机会分享我在亚太地区工作,主要在世界卫生组织过去25年工作中营养学的变化。1988-89通过意大利合作我帮助在中国四川成都启动儿童营养中心。25年前在中国城乡的营养问题,与该地区许多国家发现的问题相似。与中国一样,在过去的二十年这些国家经历了经济的快速发展和健康模式的变化。儿童营养的主要问题必须要做的事是婴幼儿喂养方法,该地区很多妇女转向不母乳喂养婴儿:贫血、蛋白质能量营养不良和佝偻病频发。中国和其他国家是如何应对这些和其他营养问题?在20世纪90年代全球营养界开始研究分析和解决营养问题的框架。1992年,在第一届FAO/WHO国际营养大会上,159个国家展示了国家营养相关文件,并同意制定国家营养计划。在2014年,22年之后,FAO和WHO再次邀请各国复审本国的营养状况和计划。今天的流行病的情况大相径庭。许多亚太国家在经济发展取得了显著成就进展,包括营养不良减少。要实现所制定的千年发展目标,现在有必要缓解剩余营养不足的问题,减少社会阶层之间的不平等,而且还可以防止和控制超重/肥胖和慢性非传染性疾病的日益严重的威胁。评估、监测和评估计划以促进实现营养千年发展目标进度,现在要求不仅注重生物学的结果,同时也应关注粮食安全、项目的过程和政策环境。
关键词:回顧、营养、亚太地区、25年

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Omega-3 polyunsaturated fatty acids and non-communicable diseases: meta-analysis based systematic review

DUO LI
The aim of this updated systematic review is to summarize the evidence of the effect of omega-3 polyunsaturated fatty acids (n-3 PUFA) on non-communicable diseases (NCDs). Publications of meta-analysis up to August 2014 were systematically searched from PubMed, the Cochrane and EMBASE databases. N-3 PUFAs have the following beneficial effects; cardio-protective effects, reduce ischemic stroke risk in both men and women and total stroke risk in women, increase insulin sensitivity in Asians, decrease risk of breast cancer and colorectal cancer in men. However, n-3 PUFAs may have unfavourable effects on type 2 diabetes in Caucasians. In conclusion, n-3 PUFA plays a crucial role in the prevention of NCDs, however, unfavourable effects should be considered in subjects with certain clinical conditions. Cross-cultural studies on the effect of n-3 PUFA on type 2 diabetes are needed to verify why diabetic patients with different ancestries have a different response to n-3 PUFA.

Key Words: n-3 PUFA, non-communicable disease, meta-analysis, systematic review, mechanism

 

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N-3 多不饱和脂肪酸和非传染性疾病:基于荟萃分析的系统综述
此更新的系统综述的目的是总结n-3 多不饱和脂肪酸对非传染性疾病影响的证据。从PubMed、 the Cochrane 和EMBASE 数据库系统检索了截止2014 年8月底前发表的荟萃分析。 N-3 多不饱和脂肪酸具有以下有益效果:心脏保护作用,降低男性和女性缺血性脑卒中的风险以及女性总脑卒中风险,增加亚洲人对胰岛素的敏感性,降低男性患乳腺癌和结肠癌的风险。但是,n- 3 多不饱和脂肪酸对白种人的2 型糖尿病会产生不利影响。总之, n-3 多不饱和脂肪酸在预防非传染性疾病方面起非常重要的作用。但是,对某些人群的临床情况应考虑他的不利影响。n-3 多不饱和脂肪酸对2 型糖尿病的影响需要通过跨文化研究以验证为什么不同血统的糖尿病患者对n-3 多不饱和脂肪酸的应答不同。

关键词:n-3 多不饱和脂肪酸、非传染性疾病、荟萃分析、系统综述、机制

 

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Feeding practices among Indonesian children above six months of age: a literature review on their magnitude and quality (part 1)
SONIA BLANEY, JUDHIASTUTY FEBRUHARTANTY AND SRI SUKOTJO
Background: In Indonesia, 37% of children under-five are stunted, 12% wasted and 12% overweight. Adequate feeding practices among children above 6 months of age are critical to tackle malnutrition. National surveys have been conducted to assess feeding practices but these aggregates hide geographic disparities. While several studies have been conducted in specific country locations to address this gap, no attempt has been made to reconcile available information. This paper aims to provide a comprehensive review of the literature on feeding practices among Indonesian children above six months of age. Methods: A literature search was conducted in several databases using combinations of different search terms: feeding, child, Indonesia, MPASI/complementary feeding, gizi/nutrition, factor, determinant, praktek/practices. All documents were reviewed using a three-step procedure to assess content appropriateness and research quality. Available information was analyzed using current recommendations on feeding practices. Results: Dietary diversity, consumption of iron-rich foods, active feeding and hygiene practices were among the non-optimal feeding practices. Consequently dietary intakes are not fulfilled for several micronutrients. Some feeding practices are worst in younger children. Differences between data from national and site-specific surveys are noted. Overall quality of the surveys needs to be strengthened. Conclusions: Generally, child feeding practices are not optimal. Indicators used to assess components of child feeding vary and make inter-survey comparisons challenging. The results also stress the need to investigate the underlying factors to optimal child feeding practices. The results may be used for advocacy of additional resource allocation for effective child feeding promotion programs.
Key Words: complementary food, feeding practices, dietary intake, literature review, Indonesia

 

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印度尼西亚六个月以上儿童的喂养方式:规模和质量的文献综述(第一部分)
背景:在印度尼西亚,五岁以下儿童发育迟缓占37%,虚弱和超重分别为12%。六个月以上儿童适当的喂养方式是解决营养不良的关键。全国性的调查已对喂养方式进行了评估,但这种集合数据隐含着地域差异。为了解决这一差异,虽然在特定的农村进行了一些研究,但没有尝试对现有信息的校正。本研究旨在为印度尼西亚六个月以上儿童喂养方式提供一个全面的文献综述。方法:使用不同的搜索词组合在多个数据库中进行文献检索,搜索词有:喂养、儿童、印度尼西亚、MPASI/辅食、gizi/营养、因子、决定因素和praktek/方式。用三个步骤来审查所有文献内容的适当性和研究质量。使用目前推荐的喂养方式分析了现有的信息。结果:膳食多样性、富含铁食物的消费、积极的喂养和卫生习惯并非最优的喂养方式之一,因此膳食摄入不能满足多种微量营养素。幼儿中存在一些最差的喂养方式。说明来自国家和特定地区的普查之间存在差别,普查的整体质量有待加强。结论:概括来说,儿童的喂养方式不是最优的。用于评价儿童喂养成分的指标的不一致使得不同普查之间的比较具有挑战性。结果还强调有必要调查最优儿童喂养方式的潜在因素。该结果可用于有效幼儿喂养推广计划额外的资源分配的宣传。
关键词:辅食、喂养方式、膳食摄入、文献综述、印度尼西亚


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Feeding practices among Indonesian children above six months of age: a literature review on their potential determinants (part 2)
SONIA BLANEY, JUDHIASTUTY FEBRUHARTANTY AND SRI SUKOTJO
Background: Feeding practices among young children are not optimal in Indonesia. Improving these practices is crucial to prevent and reduce malnutrition among young children. A better understanding of the underlying factors to appropriate practices is essential to address barriers and identify opportunities to optimal practices. This paper aims to shed light on potential determinants of feeding practices among children above 6 months of age. Methods: A systematic research of several databases using combinations of different search terms: feeding, child, Indonesia, MPASI/complementary food, gizi/nutrition, factor, determinant, praktek/practices was conducted. All documents were reviewed using a three-step procedure to assess content appropriateness and research quality. Data were analyzed using the Hector’s framework on behaviour change. Results: Available data on individual factors influencing feeding practices related mainly to mother’s attributes, namely knowledge, perceptions, attitudes, beliefs and skills. Some of them are positively linked to good practices. Some environmental-related factors such as health services, home and peer environment were conducive to improved practices. Studies on societal factors were mostly restricted to food systems which do not favour optimal feeding practices. Conclusions: The review provides insights on underlying factors conducive to optimal feeding practices. Yet, relevant and quality research is required to get a better understanding on factors related to the environment and society as well as on how they are related with each other and operate in different contexts. Indonesia has already experimented successful programs which can be used as a reference to strengthen young child feeding practices.
Key Words: determinants, feeding practices, mother’s attributes, environments, Indonesia
 

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印度尼西亚六个月以上儿童的喂养方式:潜在决定因素的文献综述(第二部分)
背景:印度尼西亚幼儿的喂养方式不是最优的。改善这些喂养方式对预防和降低幼儿营养不良至关重要。更好地了解合适喂养方式的潜在因素对解决最佳喂养方式中的障碍和找准最佳实践机会是必需的。本文旨在探讨6 个月以上儿童喂养方式的潜在决定因素。方法:使用不同的搜索词组合在多个数据库中进行文献检索,搜索词有:喂养、儿童、印度尼西亚、MPASI/辅食、gizi/营养、因子、决定因素和praktek/方式。用三个步骤来审查所有文献内容的适当性和研究质量。行为改变数据是用Hector 框架分析的。结果:现有数据中影响喂养方式的个体因素主要是妈妈的属性,即知识、观念、态度、信念和技能。他们中的一些与好的喂养方式正相关。一些环境相关的因素,比如医疗服务、家庭和同伴环境有利于改善喂养方式。对社会因素的研究大多限于食物系统,这不利于最优的喂养方式。结论:本综述提供了有利于最佳喂养方式的潜在因素的见解。然而,相关性和质量研究需要更好地了解环境和社会相关因素,以及它们之间的相互作用和在不同的背景下的运作。印度尼西亚已经有试验成功的项目,这些项目可以作为参考来加强幼儿喂养方式。
关键词:决定因素、喂养方式、妈妈的特征、环境、印度尼西亚
 

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Early enteral nutrition for upper digestive tract malformation in neonates
WEIWEI JIANG, XIAOFENG LV, XIAOQUN XU, QIMING GENG, JIE ZHANG AND WEIBING TANG

Background: Early enteral nutrition (EEN) is better than total parenteral nutrition (TPN) for many reasons. Our aim was to determine the safety and feasibility of EEN using a jejunum feeding tube in the duodenum or jejunum for congenital obstruction in neonates post-operatively. Methods: This was a retrospective review of 120 patients who had duodenal and jejunal congenital obstructions in our hospital. The patients were categorized into two groups (EEN group [n=70 patients] and control group [n=50 patients]). Differences in operative time, postoperative time to tolerate oral feeding (40 mL/3 h), post-operative hospital stay, and complications, such as catheter obstruction, diarrhea, and nutrition index, were reviewed. Results: The operative time and time to first defecation post-operatively was not significantly different between the two groups. The time to tolerate oral feeding (40 mL/3 h) and the hospital length of stay post-operatively for the EEN group were significantly shorter than the control group. Total protein, pre-albumin, and retinol binding protein were significantly higher in the EEN group than the control group 14 days post-operatively. The incidence of cholestasis and obstruction in the EEN group was significantly lower than the control group, and the incidence of diarrhea was lower than the control group, but not significantly lower. Conclusion: EEN using a jejunal feeding tube in an upper digestive tract malformation in newborns post-operatively is safe, easy, and has fewer complications.
Key Words: jejunum nutrition tube, enteral nutrition, duodenum or jejunum congenital obstruction, neonate
 

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早期肠内营养在新生儿上消化道梗阻中的应用
背景:已有的研究证明早期肠内营养优于完全肠外营养。我们的研究目的是探讨早期肠内营养(采用空肠营养管的方法)在新生儿十二指肠或空肠梗阻术后使用的安全性和可行性。方法:我们回顾性研究本院120 例十二指肠或空肠梗阻的病人。这些病人被分为两组,早期肠内营养组(70 例),完全肠外营养组即对照组(50 例)。我们比较两组的手术时间、术后经口喂养达到40mL/3 h 的时间、术后住院时间、并发症如导管堵塞、腹泻等及术后营养指标。结果:手术时间和术后首次排便时间两组间没有显著性差异。经口喂养达到40 mL/3 h 的时间和术后住院时间肠内营养组均明显短于完全肠外营养组。术后14 天时总蛋白、前白蛋白及视黄醇结合蛋白肠内营养组明显高于完全肠外营养组。胆汁淤积的发生率肠内营养组明显低于完全肠外营养组。腹泻发生率肠内营养组低于完全肠外营养组,但无统计学意义。结论:采用空肠营养管的早期肠内营养方法在新生儿上消化道梗阻术后使用是可行的,并且并发症较少。
关键词:空肠营养管、肠内营养、十二指肠或空肠先天性梗阻、新生儿

 

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Comparison of a three-in-one total nutrient mixture with conventional peripheral parenteral nutrition in children
DAE YONG YI AND HYE RAN YANG
Background: The aim of this study was to compare clinical aspects of the application of three-in-one total nutrient mixture (TNA) for peripheral parenteral nutrition (PPN) with those of the conventional PPN (cPPN) method of providing short-term parenteral nutrition for pediatric inpatients. Methods: We conducted a retrospective study in children from 2 to 18 years old who were hospitalized and underwent PPN administration. We compared clinical aspects of two methods of PPN, cPPN (n=39) and TNA (n=57). Results: The mean age was 6.5±3.1 years in the cPPN group and 8.2±3.4years in the TNA group (p=0.015). In the TNA group, there was a significantly shorter period between the day of admission and the first day of PPN or oral feeding (p<0.0001 & p<0.0001, respectively).The TNA group also fasted for a shorter period before PN after admission, and the total duration of fasting was also shorter (p<0.0001 & p<0.0001, respectively). The TNA group showed a lower glucose infusion rate and fewer daily administered total calories per weight (p<0.0001 & p=0.001, respectively). However, there was no significant difference in the amount of administered amino acids and lipids (p=0.584 & p=0.650, respectively) and PPN-related complications. Conclusions: When providing nutrients to hospitalized children who cannot take in enough nutrients via the enteral route, TNA formula may be an easier and faster method than cPPN.
Key Words: parenteral nutrition, peripheral, total nutrient mixture, child, standard nutrition

 

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儿童三效合一的全营养混合液与传统肠外营养比较
背景:本研究的目的为儿科住院病人提供短期三合一的全营养混合液(TNA)与采用外周静脉营养(PPN)的传统肠外营养(cPPN)的临床应用进行比较。方法:我们对2 到18 岁的住院并接受了肠外营养的儿童进行回顾性研究。对PPN 和cPPN (39 例)与TNA (57 例)两种营养的方法进行临床效果比较。结果:cPPN 组和TNA 组的平均年龄分别为6.5±3.1 岁和8.2±3.4(p=0.015)岁。在TNA 组中,入院当天到开始PPN 或者口服的第一天的时间明显缩短(p<0.0001 、 p<0.0001)。TNA 组还缩短了在入院后肠外营养前的时间,总的空腹时间也缩短了(p<0.0001 、 p<0.0001)。TNA 组的结果显示较低的葡萄糖输液率,更少的每日单位体重总热量摄入(p<0.0001 、p=0.001)。但是,氨基酸和脂类摄入量与PPN 相关并发症之间无显著差异( p=0.584 、p=0.650)。结论:当为那些不能通过肠内途径摄取足够营养的住院儿童提供营养时,TNA 比cPPN 更简便快捷。
关键词:肠外营养、外周、全营养混合液、儿童、营养标准


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Early jejunal feeding by bedside placement of a nasointestinal tube significantly improves nutritional status and reduces complications in critically ill patients versus enteral nutrition by a nasogastric tube
BING WAN, HAIYAN FU AND JIANGTAO YIN
Background and Objective: Unguided nasojejunal feeding tube insertion success rates are low. Controversy persists about how to safely and efficiently perform enteral nutrition (EN) in critically ill patients. This study explores an innovative blind nasointestinal tube (NIT) insertion method and compares nasogastric and nasointestinal feeding. Methods: Seventy critically ill patients admitted to the intensive care unit (ICU) were divided randomly into a nasogastric tube group (NGT; n=35) and an NIT group (NIT; n=35). After bedside NGT and blind-type NIT insertion, tube position was assessed and EN was started on day 1. Patients’ nutritional status parameters, mechanical ventilation duration, average ICU stay, nutritional support costs, and feeding complications were compared. Results: Pre-albumin and transferrin levels on days 7 and 14 were significantly higher in the NIT group than in the NGT group (p<0.01, p<0.05). Bloating, diarrhea, upper gastrointestinal bleeding, and liver damage did not differ significantly between groups (p>0.05). Interleukin-6 and tumor necrosis factor-α levels and APACHE II score were significantly lower in the NIT group than in the NGT group (p<0.01, p<0.05). Reflux and pneumonia incidences, mechanical ventilation duration, average ICU stay length, and nutritional support costs were significantly lower in the NIT group than in the NGT group (p<0.01). Conclusion: Blind bedside NIT insertion is convenient and its use can effectively improve nutritional status, reduce feeding complications, and decrease nutritional support costs of critically ill patients.
Key Words: jejunal feeding, pre-albumin, aspiration pneumonia, interleukin-6
 

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早期盲法置入鼻肠管行肠内营养与鼻胃管相比可以显著改善危重患者的营养及炎症状态
本研究探讨改良的盲插型鼻肠管的置入方法,并比较鼻肠管及鼻胃管进行肠内营养后患者的营养状态、炎症指标及肠内营养的费用及并发症发生率。入住ICU的危重症患者70例随机分为鼻胃管组(NGT;n=35)和经鼻腔置入鼻肠管组(NIT;n=35)。比较了患者的营养相关指标、机械通气及ICU住院日、记录肠内营养并发症发生率及肠内营养费用等。第7、14天,NIT组的PA及TF水平明显高于NGT组(p<0.01,p<0.05)。两组间腹胀、腹泻、上消化道出血及肝功能损害无统计学差异,但反流及吸入性肺炎发生率、机械通气时间、ICU平均住院日和肠内营养支持费用,NIT组均明显低于NGT组(p<0.01)。IL-6和TNF-α水平及 APACHE II评分,NIT组显著低于NGT组(Day 7,p<0.01;Day 14,p<0.05)。使用新型鼻肠管并改良盲插方式,可以提高盲插成功率。更重要的是,及时使用鼻肠管肠内营养,可以显著改善重症患者的营养状况、炎症反应及肠内营养的支持费用和相关并发症。
关键词:空肠置入、前白蛋白、吸入性肺炎、白细胞介素-6


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Impacts of dietary fat changes on pregnant women with gestational diabetes mellitus: a randomized controlled study
HUIYAN WANG, HONGYI JIANG, LIPING YANG AND MING ZHANG
Objective: This study aims to determine the impact of increasing polyunsaturated fatty acid intake on blood glucose, lipid metabolism, and pregnancy outcomes of pregnant women with gestational diabetes mellitus. Methods: Under constant total energy and protein intake, 84 pregnant women with gestational diabetes mellitus were randomly divided into the experimental and control groups, which were given oil-rich and conventional low-oil meals, respectively. Results: After the dietary intervention, the intake and energy supply of fat and the three fatty acids were significantly higher in the experimental group than the control group (p<0.001). The intake and energy supply of polyunsaturated fatty acids increased significantly post-intervention in the experimental group but did not change in the control group. In both the intervention and the control group, fasting blood glucose, 2 h postprandial plasma glucose, and the insulin resistance index decreased significantly post-intervention (p<0.05); the lipid changes were consistent between groups. Pregnancy outcomes did not differ significantly between the two groups (p>0.05). Conclusions: An appropriate increase in polyunsaturated fatty acid intake benefits pregnant women with gestational diabetes mellitus as well as fetuses, as long as the diet therapy follows basic recommendations and total energy intake is strictly controlled.
Key Words: gestational diabetes mellitus, diet structure, vegetable oil, fatty acids, blood lipid
 

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一项随机对照研究:饮食中的脂肪变化对孕妇妊娠期糖尿病的影响
目的:观察增加植物油中多不饱和脂肪酸的摄入对妊娠期糖尿病孕妇血糖、脂质代谢以及妊娠结局的影响。方法:84 例GDM 孕妇,孕24~28 周,不伴有其他妊娠合并症和并发症,随机分为实验组41 例,对照组43 例,在总能量和蛋白质摄入量相同情况下,给予实验组多油配餐,对照组为传统少油配餐。结果:饮食干预后,实验组脂肪和三种脂肪酸摄入量和供能比均高于对照组(p<0.001),实验组多不饱和脂肪酸摄入量和供能比较干预前增加,对照组多不饱和脂肪酸摄入量无改变。两组空腹血糖、餐后2h 血糖、胰岛素抵抗指数均较干预前显著降低(p<0.05),两组的血脂变化一致;两组妊娠结局差异无统计学意义。结论:GDM 的饮食治疗只要遵照基本规则,严格控制总能量的摄入,适当增加植物油中多不饱和脂肪酸的摄入对孕妇和胎儿是有益的。
关键词:妊娠期糖尿病、膳食结构、植物油、脂肪酸、血脂

 

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BMI status influences the response of insulin sensitivity to diacylglycerol oil in Chinese type 2 diabetic patients
JU-SHENG ZHENG, LING WANG, MEI LIN, HONG YANG AND DUO LI

Present study was a post-hoc analysis and aimed to examine the influence of adiposity status on the response of insulin sensitivity to diacylglycerol (DAG) oil in type 2 diabetic patients. A total of 127 type 2 diabetic patients were recruited into a randomized double-blind controlled parallel trial in Hangzhou, China. Subjects were allocated to consume the same amount (25 mL/d) of DAG (n=66) or triacylglycerol (TAG) oil (n=61) with similar fatty acid compositions for 120 days. Marginally significant interaction was observed between BMI status (overweight versus normal weight) and test oils for fasting insulin (p-interaction=0.046) and Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) (p-interaction=0.059). For normal weight subjects (BMI25), DAG group showed significant decrease of fasting insulin (-2.0, 95% CI: -3.90, -0.10; p=0.036) and HOMA-IR (-0.69, 95% CI: -1.36, -0.03; p=0.015), but not in the TAG group. No significant change of either trait in DAG or TAG group was observed for overweight subjects (BMI>25). In summary, the effect of DAG oil on insulin sensitivity in type 2 diabetic patients is influenced by the baseline BMI status. Type 2 diabetic patients may benefit from DAG oil in terms of insulin sensitivity improvement, however only when they are in normal body weight range.
Key Words: BMI, diacylglycerol, insulin sensitivity, randomized controlled trial, type 2 diabetes

 

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BMI状态影响中国2型糖尿病患者的胰岛素敏感性对甘油二酯的应答
本项二次分析的目的是探讨在中国2型糖尿病患者中进行甘油二酯的干预时,患者的肥胖状态对其胰岛素敏感性变化的影响。此项随机双盲对照试验共在中国杭州纳入了127名2型糖尿病患者,所有患者被随机分配到两个组,分别食用相同体积( 25 mL/d ) 及相似脂肪酸含量的甘油二酯( n=66 ) 和甘油三酯(n=61),持续120天。对空腹胰岛素(p-交互=0.046)和空腹胰岛素抵抗指数(p-交互=0.059),BMI状态(超重vs 正常体重)和两种油类干预都有边缘性显著的交互作用。在正常体重患者中(BMI≤25),甘油二酯干预能够使空腹胰岛素(-2.0, 95% CI: -3.90, -0.10; p=0.036)和胰岛素抵抗指数水平(-0.69, 95% CI: -1.36, -0.03; p=0.015)显著下降,但甘油三酯没有该作用。在超重患者中,甘油二酯和甘油三酯干预对两种指标都没有显著影响。综上所述,甘油二酯对2型糖尿病患者胰岛素敏感性的影响受患者基线BMI状态的影响。当2型糖尿病患者处于正常体重范围内时,食用甘油二酯可能对其胰岛素敏感性的改善有益处。
关键词:BMI、甘油二酯、胰岛素敏感性、随机对照试验、2型糖尿病


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Dietary modifications to improve micronutrient status of Indian children and adolescents with type 1 diabetes
LAVANYA S PARTHASARATHY, SHASHI A CHIPLONKAR, ANURADHA V KHADILKAR AND VAMAN V KHADILKAR
Introduction: Diet plays a crucial role for maintaining normal growth and development while optimizing glycemic control in children with diabetes. Dietary restrictions, in a diabetic child’s diet may lead to micronutrient deficiencies. Objectives: To examine dietary nutritional deficiencies of Asian Indian children with Type 1 diabetes mellitus and develop micronutrient-rich recipes suitable for them. Methods: Anthropometry, diet (3-day recall) of 70 children with diabetes (24 boys) was recorded. Daily nutrient intakes and nutrient content of recipes were estimated using CDIET version 2.0. Results: Mean intake amongst children for energy was 79% of Indian Recommended Dietary Allowance (RDA), protein was 105% RDA, but fat intakes were high (143% RDA). Mean intakes of riboflavin, β carotene, zinc, iron were less than 50%, and thiamin and calcium were around 60% RDA suggesting a possible multiple micronutrient deficiency. Based on popularly consumed snacks, 20 healthy recipes were devised that can be incorporated in children’s diet. Mean energy content of new recipes was similar to routine snacks (281±28 kcal/100 g vs 306±27 kcal/100 g cooked weight). However, the mean vitamin and mineral content of new recipes was significantly higher (p<0.01). There was a five-fold increase in total mineral content (zinc, calcium and iron) and twofold increase in total vitamin content (β carotene, vitamin C, vitamin B-1, B-2, and B-3) in new recipes compared with the routine snacks. Conclusion: Multiple dietary micronutrient deficiencies are observed in diabetic children. Addition of newly developed recipes in their everyday diet may help to enhance micronutrient intakes without increasing their energy load.
Key Words: diabetes mellitus, type 1, Asian Indian snacks, micronutrients, children
 

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通过调整饮食改善印度儿童和青少年1 型糖尿病患者微量元素状况
引言:对糖尿病患儿来说,饮食在优化控制血糖同时还会对儿童正常生长发育至关重要。糖尿病儿童的饮食限制可能会导致微量元素缺乏。目的:探讨亚洲的印度1 型糖尿病儿童的膳食营养缺乏和开发适合他们含有丰富微量元素的食谱。方法:记录了70 名糖尿病患儿(24 名男童)人体测量学参数及3天饮食回忆。用CDIET 2.0 估计每日营养素摄入量及食谱的营养素含量。结果:儿童平均摄入的能量是印度推荐膳食供给量(RDA)的79%,蛋白质为RDA 的 105%,而脂肪较高(RDA 的143%)。而核黄素、β 胡萝卜素、锌、铁的平均摄入量低于RDA 的50%,硫胺素和钙分别在RDA 的60%左右,提示多种微量元素缺乏。基于流行消费的零食,新设计的20 种健康食谱可纳入儿童的饮食。新食谱的平均能量含量于常规食谱相似(281±28 kcal/100 g 、306±27 kcal/100 g 熟重)。而新食谱的平均维生素和矿物质含量都明显高于常规小吃(p<0.01)。与传统配方相比,总矿物质含量(锌、钙、铁)增加5倍,总维生素含量(β 胡萝卜素、维生素C、维生素B-1、B-2 和B-3)增加了两倍。结论:糖尿病儿童的饮食中缺乏多种微量元素。新食谱可以在不增加他们能量负担的同时增加微量元素摄入量。
关键词:糖尿病、1 型、亚洲的印度食谱、微量元素、儿童

 

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Associations of decreased serum transthyretin with elevated high-sensitivity CRP, serum copper and decreased hemoglobin in ambulatory elderly women
AYAKA TSUBOI, MAYU TERAZAWA-WATANABE, TSUTOMU KAZUMI AND KEISUKE FUKUO
Background: Transthyretin (TTR), a sensitive indicator of malnutrition and inflammation, has been shown to be associated with mortality in elderly population. Methods: We examined relationships between serum TTR and a range of risk factors for mortality in 185 free-living elderly women. Blood was drawn between breakfast and lunch. Results: TTR was correlated negatively with age (r= -0.30, p<0.001). After controlling for age, TTR was negatively associated with log high-sensitivity CRP (hsCRP) and serum copper. It was positively associated with albumin, serum iron and hemoglobin. In addition, TTR was positively correlated with systolic and diastolic blood pressure and postprandial triglyceride (TG). In multiple regression analysis for TTR as a dependent variable, hemoglobin (standardized β, 0.244), serum copper (standardized β, -0.134), postprandial TG (standardized β, 0.223) and log hsCRP (standardized β, -0.190) emerged as determinants of TTR independently of age, albumin, serum iron, systolic and diastolic blood pressure, and explained 22.8% of TTR variability. Conclusions: Subclinical low-grade inflammation, elevated serum copper and decreased hemoglobin were associated with decreased serum TTR in community-living elderly Japanese women and may represent important confounders of the relationship between low TTR and mortality in the elderly. The positive association of TTR with postprandial TG warrants further investigation.
Key Words: copper, low-grade inflammation, hemoglobin, postprandial triglyceridemia, transthyretin
 

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老年女性血清甲状腺素降低与升高的高敏C 反应蛋白和血清铜以及降低的血红蛋白之间的关系
背景:甲状腺运载蛋白(TTR)是反映营养不良和炎症的一个敏感指标,已被证实与老年人口死亡率有关。方法:我们研究了185 名独立生活的老年妇女血清TTR 和一系列死亡风险因素之间的关系。血液在早餐和午餐之间抽取。结果:TTR 与年龄呈负相关(r=-0.30,p<0.001)。在控制了年龄因素后,TTR 与高敏C 反应蛋白(hsCRP)的对数和血清铜呈负相关,与白蛋白、血清铁、血红蛋白呈正相关。此外,TTR 与收缩压、舒张压、餐后甘油三酯(TG)呈正相关。在以TTR 为因变量的多元回归分析中,独立于年龄、白蛋白、血清铁、收缩压和舒张压,血红蛋白(标准化β,0.244)、血清铜(标准化β,- 0.134)、餐后TG(标准化β,0.223)和高敏C 反应蛋白对数(标准化β,0.190)解释了TTR 变率的22.8%。结论:亚临床轻度炎症,升高的血清铜和降低的血红蛋白可能与日本社区老年妇女血清TTR 下降有关,并且有可能是老年人低浓度TTR 和死亡率关系的混杂因素。TTR 与餐后TG 值的相关性有待进一步研究。
关键词:铜、轻度炎症、血红蛋白、餐后甘油三酯血症、甲状腺素

 

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Dairy consumption and risk of cardiovascular disease: an updated meta-analysis of prospective cohort studies
LI-QIANG QIN, JIA-YING XU, SHU-FEN HAN, ZENG-LI ZHANG, YOU-YOU ZHAO AND IGNATIUS MY SZETO
Background: Epidemiological studies to-date provided inconsistent findings on the effects of dairy consumption on the risk of cardiovascular disease (CVD). We aimed to examine the association of dairy consumption and its specific subtypes with CVD risk, including the risk of stroke and coronary heart disease (CHD) by a metaanalysis. Methods: PubMed, EMBASE, and Cochrane Library databases were searched for articles published up to February 2014 to identify prospective cohort studies. Random-effects model or fix-effects model was used to compute the summary risk estimates. Results: A total of 22 studies were eligible for analysis. An inverse association was found between dairy consumption and overall risk of CVD [9 studies; relative risk (RR)=0.88, 95% confidence interval (CI): 0.81, 0.96] and stroke (12 studies; RR=0.87, 95% CI: 0.77, 0.99). However, no association was established between dairy consumption and CHD risk (12 studies; RR=0.94, 95% CI: 0.82, 1.07). Stroke risk was significantly reduced by consumption of low-fat dairy (6 studies; RR=0.93, 95% CI: 0.88, 0.99) and cheese (4 studies; RR=0.91, 95% CI: 0.84, 0.98), and CHD risk was significantly lowered by cheese consumption (7 studies; RR=0.84, 95% CI: 0.71, 1.00). Restricting studies according to various inclusion criteria yielded similar results for CVD and CHD analyses, but showed attenuated results for stroke analysis. Heterogeneity across studies was found for stroke and CHD analyses, and publication bias was found for stroke analysis. Conclusion: This meta-analysis provided further evidence supporting the beneficial effect of dairy consumption on CVD. Low-fat dairy products and cheese may protect against stroke or CHD incidence.
Key Words: dairy, cardiovascular disease, stroke, coronary heart disease, meta-analysis

 

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奶制品消费和冠心病发病风险:前瞻性队列研究的meta 分析
背景:目前有关奶制品消费和心血管疾病(CVD)发病风险的流行病学研究结论并不一致,本研究采用meta 分析的方法探讨了奶制品与总的CVD、中风以及冠心病发病风险的关系。方法:我们搜索了PubMed、EMBASE 和Cochrane图书馆等数据库(截止2014 年2 月)中相关的前瞻性队列研究,采用固定效应模型或随机效应模型计算总效应值。 结果:最终22 个研究纳入meta 分析,奶制品消费和总的CVD [9 个研究; 相对危险度(RR)=0.88,95%可信区间(CI):0.81,0.96]以及中风(12 个研究; RR=0.87, 95% CI:0.77, 0.99)呈负相关,但是没有发现奶制品消费和冠心病之间存在相关性(12 个研究; RR=0.94,95% CI:0.82,1.07)。低脂奶制品(6 个研究;RR=0.93,95% CI:0.88,0.99)和奶酪(4 个研究;RR=0.91,95% CI:0.84,0.98)消费显著降低中风的发病风险,奶酪(7 个研究;RR=0.84,95% CI:0.71,1.00)还显著降低冠心病的发病风险。根据不同的入选标准限定研究后没有明显改变CVD 和冠心病的结果,但削弱了奶制品消费和中风的关系。中风和冠心病的研究存在异质性,中风的研究还显示存在发表偏倚。 结论:我们的meta 分析进一步证实奶制品消费有利于预防CVD,低脂奶制品和奶酪降低了中风和冠心病的发病风险。
关键词: 奶制品、心血管疾病、中风、冠心病、meta 分析


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Intake of cruciferous vegetables is associated with reduced risk of ovarian cancer: a meta-analysis
JIYI HU, YIWANG HU, YETING HU AND SHU ZHENG
Background: Epidemiological studies on the association between cruciferous vegetable (CV) consumption and the risk of ovarian cancer have demonstrated inconsistent results. We conducted a meta-analysis on CV consumption and ovarian cancer risk. Methods: The relevant studies were identified by searching the Medline (Pubmed), Embase and Web of Science databases. The references of related articles and reviews up to October 2013 were also screened. The pooled relative risks (RRs) with 95% confidence intervals (CIs) for the highest versus the lowest CV consumption levels were calculated using a random-effects model. The heterogeneity and publication bias were also evaluated. Results: Eight studies (4 case-control studies and 4 cohort studies) were identified and included in this meta-analysis. When all studies were pooled together, there was a significantly inverse association between CV consumption and the risk of ovarian cancer (RR: 0.89; 95% CI: 0.81-0.99). No significant heterogeneity or publication bias was found. Conclusions: The findings from this study suggest that the consumption of CVs may reduce the risk of ovarian cancer. Further investigations are needed to confirm the clinical effect of CVs on ovarian cancer.
Key Words: cruciferous vegetables, ovarian cancer, epidemiological study, cancer prevention, meta-analysis
 

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十字花科蔬菜的摄入可降低卵巢癌的发病风险:基于观察性研究的荟萃分析
背景:基于流行病学的研究显示,关于十字花科蔬菜的摄入是否能降低卵巢癌发生风险尚存在争议。本研究的目的是通过荟萃分析,探讨十字花科蔬菜摄入与卵巢癌的发生风险的相关性。方法:通过检索Medline(Pubmed)、Embase 和Web of science 数据库来查找相关研究(截止至2013 年10 月)。采用随机效应模型来计算整合的相对风险以及其95%置信区间,并评价研究的异质性和发表偏倚。结果:符合入选标准的研究共有8 项(4 项病例对照研究和4 项队列研究)。通过分析发现,十字花科蔬菜高摄入相比于低摄入能显著降低卵巢癌的发生风险(RR:0.89;95% CI:0.81-0.99)。没有发现研究存在显著的异质性或发表偏倚。结论:本研究提示十字花科蔬菜高摄入可降低卵巢癌的发生风险,当然,十字花科蔬菜对卵巢癌的临床效果尚需进一步的研究来证实。
关键词:十字花科蔬菜、卵巢癌、流行病学研究、癌症预防、荟萃分析
 

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Change in weight status and academic performance among senior high school students in Taiwan
PEI-AN LIAO, HUNG-HAO CHANG, JIUN-HAO WANG AND MIN-CHEN WU
Introduction: This study examines how the changes in weight status across the spectrum of a senior high school study are associated with academic performance measured by the university entrance exam scores. Materials and Methods: A unique dataset which compiles a national health examination profile and the General Scholastic Ability Test data bank in Taiwan was constructed. The final sample comprised 149,240 senior high school students of which 70,662 were males and 78,578 were female students. The school-level fixed effect models were estimated. Results: Students who were either (a) not overweight in the first year but overweight in the third year of senior high school, (b) overweight in both the first and third year, or (c) overweight in the first year but not overweight in the third year, were more likely to score lower on the university entrance exam, compared with their never-overweight counterparts. The findings differ by gender and test subjects. Discussions: The change in weight status during senior high school period is associated with subsequent university entrance exam outcome. Students who start senior high school being overweight should be paid attention. School-based programs and practices need to be implemented to reduce the prevalence of overweight among students.
Key Words: obesity, overweight, academic performance, senior high school students, Taiwan
 

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臺灣高中生體重變化與學業表現關係之探討
本文旨在探討臺灣高中生求學階段的體重變化狀況與其大學入學成績之關係。研究資料使用全國體檢數據與大學學科能力測驗成績的合併資料檔,有效樣本數為149,240位高中生,其中男、女學生分別為70,662與78,578人,並使用學校層級的固定效果模型進行估計。重要的分析結果,發現(a)高一時期體重正常,但至高三時變為超重、(b)高一與高三時期體重皆為超重者、(c)高一時超重,但至高三則變為正常体重者,與從未曾有過超重的對照組相比,這三類人群的大學入學考試成績偏低。體重變化與大學入學考試成績間的關聯,因性別與考試科目之不同而有所差異。本結果發現高中生在求學過程中的體重變化狀況會影響到其後的大學入學考試成績,故本研究建議有關單位未來應特別關注超重高中新生,為其應建立以學校為基礎的體重控制計畫,以降低超重的發生率。
关键词:肥胖、過重、學業表現、高中生、臺灣


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Weight-related stigmatization and binge eating among overweight adults in Southern Taiwan
YA-KE WU AND YI LIU
Objective: The purpose of this study was to investigate the association between the level of weight-related stigmatizing experiences and binge eating in overweight adults in southern Taiwan. Methods: This study design was a cross-sectional questionnaire survey with convenience sample. A total of 141 questionnaires were analyzed. Results: The study showed that 97.9% participants had at least one weight-related stigmatizing experience in their lifetime. The main sources of weight-related stigmatizing experiences were from either parents, relatives or doctors. BMI and age were significantly correlated with weight-related stigmatizing experiences. Furthermore, about 19.9% of participants experienced binge eating. The scores of the weight-related stigmatizing experiences and binge eating were positively correlated (r=0.33, p<0.01). The scores of the weight-related stigmatizing experiences and monthly income significantly explained factors of binge eating. Conclusions: The findings showed that there is a need to develop interventions to assist overweight people cope with weight-related stigmatization and prevent binge eating in the future.
Key Words: weight-related stigmatization, binge eating, overweight, Taiwan, cross-sectional study


 

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台灣南部超重成年人體重歧視和狂食
目的:本研究探討台灣南部超重成年人體重歧視經歷與狂食程度之相關性。方法:本研究採橫斷性研究法,以結構式問卷及方便取樣收案,共收集有效樣本141 位。結果:研究結果顯示97.9%的受試者一生中至少有過一次體重歧視經歷,主要的體重歧視經歷來自于父母、親戚或醫師。BMI 及年齡與體重歧視經歷顯著相關。此外,約有19.9%的受試者有狂食的經歷。體重歧視經歷程度與狂食程度呈顯著正相關(r=0.33,p<0.01),而體重歧視經歷程度與月收入為影響狂食程度之顯著因素。結論:本研究結果建議未來有必要制定干預措施來幫助超重人群處理體重歧視,並避免狂食行為發生。
關鍵字:體重歧視、狂食、超重、台灣、橫斷性研究

 

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Circulating IGF-1 may mediate improvements in haemoglobin associated with vitamin A status during pregnancy in rural Nepalese women
MARGIA A ARGUELLO, KERRY J SCHULZE, LEE SF WU, MICHELE L DREYFUSS, SUBARNA K KHATRY, PARUL
CHRISTIAN AND KEITH P WEST
Pregnancy exacerbates vitamin A (VA) deficiency and anaemia among women in developing countries. Improving circulating haemoglobin (Hb) requires erythrocyte production and availability of iron. Insulin-like growth factor-1 (IGF-1) functions in erythropoiesis, but its association with VA status and pregnancy-associated anaemia has not been studied. The aim of this study was to examine the relationship between serum retinol, IGF-1, and Hb among pregnant women in extant samples collected during a placebo-controlled trial of VA and beta-carotene (BC) supplementation in rural Nepal conducted from 1994 to 1997. Mid-pregnancy serum IGF-1 was measured in serum from n=589 randomly selected women of n=1186 in whom anthropometric, VA (retinol) and iron (Hb, erythrocyte zinc protoporphyrin (ZP), and ferritin) status data were available. Associations of IGF-1 with retinol, Hb or anaemia, and iron status were determined using multiple linear and logistic regression. Path analysis was used to explore the role of IGF-1 as a mediator between retinol and Hb, accounting for iron status. A 2.6 g/L increase in IGF-1 was observed per 0.1 mol/L increment in retinol (p<0.0001). Hb increased with each quartile of IGF-1, and odds of anaemia declined 68.8% from the 1st to 4th quartile. Improved iron status indicators explained only 29.1% of the association between IGF-1 and Hb, while IGF-1 explained 25.6% of the association between retinol and Hb. Increasing IGF-1 was likely one mechanism by which retinol improved circulating Hb in pregnant women of rural Nepal, although IGF-1 worked primarily through pathways independent of improved iron status indicators, perhaps by stimulating erythrocyte production.
Key Words: vitamin A, insulin-like growth factor-1, anaemia, pregnancy, haemoglobin
 

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循环IGF-1 可能介导了尼泊尔农村妇女怀孕期间的维生素A 状况相关的血红蛋白的提高
怀孕加剧了发展中国家妇女维生素A 的缺乏和贫血。提高循环血红蛋白(Hb)需要红细胞的生成和可利用的铁。胰岛素样生长因子-1(IGF-1)在红细胞生成中发挥其功能,但是尚没有其与维生素A 状况和妊娠相关贫血之间关系的研究。本研究的目的是在1994 年到1997 年间在尼泊尔农村进行的补充维生素A 和β-胡萝卜素(BC)的安慰剂-对照试验现存的样本中,研究怀孕妇女血清视黄醇、IGF-1 和Hb 之间的关系。从1186 名有人体测量、维生素A(视黄醇)和铁(血红蛋白、红细胞锌原卟啉和铁蛋白)的资料的妇女中,随机测定589 名妊娠中期妇女的血清IGF-1。采用多重线性回归和logistic 回归来确定IGF-1 和视黄醇、Hb 或贫血与铁营养状况之间的关系。采用路径分析探讨IGF-1 作为视黄醇和Hb 之间介物的作用来评估铁营养状况。观察到视黄醇每增加0.1 mol/L,IGF-1 增加2.6 g/L(p<0.0001)。Hb 随着IGF-1 四分位的增加而增加,并且从第1 个四分位到第4 个四分位,贫血风险降低了68.8%。铁营养状况改善的指标只能解释IGF-1 和Hb 之间关系的29.1%,而IGF-1 能够解释视黄醇和Hb 之间关系的25.6%。虽然IGF-1 主要通过独立改善铁营养状态指标的途径发挥作用,增加的IGF-1 通过视黄醇改善尼泊尔农村怀孕妇女的循环Hb 也可能是机制之一,可能是通过刺激红细胞生成。
关键词:维生素A、胰岛素样生长因子-1、贫血、妊娠、血红蛋白
 

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Maternal serum lipid levels during late pregnancy and neonatal body size
KUI YE, QING-LI BO, QIU-JU DU, DAN ZHANG, YING SHEN, YAN-PING HAN, YUAN-BI LI, YI LI, CHUAN-LAI HU AND LI LI
Objective: The aim of this study was to determine the predictive value of maternal serum lipid levels during late pregnancy for neonatal body size. Methods: This study was conducted from January 1, 2011 to July 31, 2012 at a Maternal and Child Health Hospital. Fasting blood glucose, serum triglyceride, total cholesterol, HDL and LDL were estimated in maternal collected before delivery. Detailed anthropometry of the neonates was performed. Results: Women who delivered a large for gestational age baby were older, taller, had a higher pre-pregnancy weight, higher pre-pregnancy BMI, and higher weight gain during pregnancy than women who delivered an appropriate for gestational age infant. After adjusting for maternal age, pre-pregnancy BMI, weight gain during pregnancy, parity, neonatal sex and gestational age at delivery, we found that only maternal HDL level was inverse associated with birth weight, length and head circumference (p<0.05). On logistic regression analysis, the significant metabolic predictors of large for gestational age was HDL (OR 0.57, 95%CI: 0.38-0.84, per 1 mmol/L increase) after adjusting for the confounders. Conclusions: Maternal serum HDL level determined in maternal blood taken close to delivery was independently associated with neonatal size and was the independent predictor for large for gestational age.
Key Words: lipids, birth weight, pregnancy, triglycerides, large for gestational age
 

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妊娠晚期母体的血脂水平与新生儿体重的关系
目的:是探讨妊娠晚期母体的血脂水平对新生儿出生体重的预测价值。方法:本研究是从2011 年1 月到2012 年7 月在一个妇幼保健院实施的,在孕妇分娩前测定母体的空腹血糖、甘油三酯、胆固醇、高密度脂蛋白和低密度脂蛋白水平,并测量新生儿的人体学资料。结果:大于胎龄儿的母亲与正常母亲相比,年龄更大、身高更高、妊娠前体重和体质指数更高。在调整了母亲的年龄、妊娠前体质指数、孕期增重、产次、新生儿性别和分娩孕周后,妊娠晚期母体的高密度脂蛋白水平与新生儿的出生体重、身长和头围成负相关(p<0.05). Logistic回归分析发现,在调整混杂因素后,大于胎龄儿的预测因子是妊娠晚期母体高密度脂蛋白水平(OR 0.57, 95% CI: 0.38-0.84)。结论:我们认为母体妊娠晚期的高密度脂蛋白水平与新生儿出生体重独立相关,是大于胎龄儿的独立预测因子。
关键词:血脂、出生体重、孕期、甘油三酯、大于胎龄儿
 

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Micronutrient status and its relationship with nutritional status in preschool children in urban Sri Lanka
ESHANI MARASINGHE, SUREKA CHACKREWARTHY, CHRISHANTHA ABEYSENA AND SHAMAN RAJINDRAJITH
Objective: To assess the micronutrient status and its relationship with nutritional status in preschool children. Methods: In a cross sectional study, anthropometric data and fasting blood samples were obtained from 340 children attending preschool in urban Sri Lanka. Serum concentrations of vitamin D, parathyroid hormone, vitamin A, zinc and haemoglobin were measured. Z-scores of anthropometric indices of height-for-age, weight-for-age and weight-for-height were computed to evaluate the nutritional status. Results: Prevalence of stunting, underweight, wasting and anaemia among children were 7.1%, 16.9%, 21.2% and 7.4%, respectively. Deficiencies of zinc and vitamin A occurred among 67% and 38% of children, respectively. Vitamin D deficiency (<10 ng/mL) and insufficiency (10-20 ng/mL) occurred in 5.0% and 29.1% of children, respectively, and12% had parathyroid hormone levels indicative of hypocalcaemia. Nutritional status was significantly correlated (p<0.05) with vitamin D status [height-for-age (r=0.10), weight-for-age (r=-0.18), weight-for-height (r=-0.12)], and with haemoglobin status [weight-for-age (r=0.11)]. Zinc and vitamin A levels were lower in severe stunting compared with normal height (p<0.05). Significant correlations (p<0.05) were observed between vitamin D and parathyroid hormone (r=-0.12) and between haemoglobin and vitamin A (r=0.01), zinc (r=0.02) and vitamin D (r=0.02) levels. Conclusions: In the surveyed population, zinc deficiency was high and to a lesser degree vitamin A deficiency and vitamin D insufficiency prevailed. The nutritional status of the children was related to vitamin D status and with haemoglobin status. Zinc and vitamin A levels were low in children with severe stunting. Vitamins A, D and zinc levels were associated with haemoglobin status.
Key Words: micronutrients, nutritional status, vitamin D, preschool children, Sri Lanka
 

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斯里兰卡城市学龄前儿童微量营养素的状况及其与营养状况的关系
目的:评估学龄前儿童微量营养素的状况及其与营养状况的关系。方法:采用横断面研究,收集斯里兰卡城市340 名学前班儿童的人体测量数据和空腹血样。测定血清中维生素D、甲状旁腺激素、维生素A、锌和血红蛋白的浓度。计算人体测量指标身高年龄比、体重年龄比和体重身高比的Z-评分进行了计算来评价营养状况。结果:儿童中发育迟缓、低体重、消瘦和贫血的发生率分别为7.1%、16.9%、21.2%和7.4%。儿童中锌和维生素A 缺乏的发生率分别为67%和38%。儿童中维生素D 缺乏(<10 ng/mL) 和不足(10-20 ng/mL)的发生率分别为5.0%和29.1%,并且甲状旁腺激素水平提示12%的儿童有低钙血症。营养状况与维生素D 状况显著相关(p<0.05)(身高年龄比,r=0.10;体重年龄比,r=-0.18;体重身高比,r=-0.12)和血红蛋白的状况(体重年龄比,r=0.11)。严重发育迟缓儿童的锌和维生素A 水平低于正常身高儿童(p<0.05)。维生素D 和甲状旁腺激素显著负相关(r=-0.12),血红蛋白和维生素A(r=0.01)、锌(r=0.02)和维生素D(r=0.02)水平显著正相关(p<0.05)。结论:在被调查的人群中,锌缺乏率略高于维生素A 缺乏和维生素D 不足的发生率。儿童的营养状况与维生素D 和血红蛋白的状况有关。严重发育迟缓儿童的锌和维生素A 水平低。维生素A、维生素D 和锌水平与血
红蛋白的状况有关。
关键词:微量营养素、营养状况、维生素D、学龄前儿童、斯里兰卡
 

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Locally produced cereal/nut/legume-based biscuits versus peanut/milk-based spread for treatment of moderately to mildly wasted children in daily programmes on Nias Island, Indonesia: an issue of acceptance and compliance?
VERONIKA SCHERBAUM, RATNA CHRISMIARI PURWESTRI, WOLFGANG STUETZ, DYAH AYU INAYATI, JULIA SURYANTAN, MAURICE ALEXANDER BLOEM AND HANS KONRAD BIESALSKI
Background: Treatment effects of fortified ready-to-use foods for moderately to mildly wasted children are largely unknown. Methods: Two nutritionally comparable forms of locally produced ready-to-use foods for daily feeding programmes of moderately to mildly wasted children (weight-for-height Z-score/WHZ>=-3 to <-1.5SD) were assessed on Nias, Indonesia. The frequencies of reaching target WHZ>=-1.5SD, compliance to the ready-touse food programme, and weight gain until recovery or programme closure among children treated with peanut/milk-based spreads (n=29) were compared among children receiving cereal/nut/legume-based biscuits (n=44) and a second group treated with cereal/nut/legume-based biscuits whose mothers received intensive nutrition education (n=38). Results: Children in the cereal/nut/legume-based biscuits groups were younger (31 and 33 vs 39 months, p=0.004) and more likely to be moderately wasted (45 and 39 vs 21% with WHZ<-2, p=0.114) at admission, but had a higher rate in recovery (84 and 79 vs 62%, p=0.086) and showed more frequently a high compliance (>80%) to the ready-to-use (86 and 84 vs 45%, p<0.001) than those children in the peanut/milk-based spreads programme. Multivariable logistic regression revealed high compliance followed by weight gain and a lower degree of wasting at admission as independent and significant predictors of reaching target WHZ>=-1.5SD (all p<0.01). Weight gain was positively associated with the consumption of the biscuits (vs peanut//milk-based spreads: r=0.188, p=0.051) and was highest in the cereal/nut/legume-based biscuits plus intensive education compared with the cereal/nut/legume-based biscuits and peanut/milk-based spreads groups. Conclusions: Locally produced ready-to-use foods as biscuits or spreads were similarly effective for rehabilitation of moderately to mildly wasted children.
Key Words: fortified ready-to-use foods (RUFs), supplementary feeding, moderately to mildly wasted children, weight gain, programme compliance
 

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本地生产的谷物/坚果/豆科植物为基础的饼干和花生/牛奶为基础的涂抹酱对印度尼西亚尼亚斯岛日常计划中轻中度虚弱儿童治疗的比较:一个接受和依从的问题
背景:强化方便食品对轻中度虚弱儿童的治疗效果在很大程度上是未知的。方法:在印度尼西亚尼亚斯岛两种本地生产的方便食品的营养堪比形式对轻中度虚弱儿童(身高别体重Z-评分/WHZ,-3SD≤WHZ<-1.5SD)日常供餐方案中进行评估。在接受花生/牛奶为基础的涂抹酱治疗的儿童(n=29)、接受谷物/坚果/豆科植物为基础的饼干治疗的儿童(n=44)和第二组接受谷物/坚果/豆科植物为基础的饼干治疗并且其母亲接受营养强化教育(n=38)的儿童中,比较其达到目标WHZ-1.5SD 的频率、对方便食品计划的依从、直到康复或计划结束时的体重增加。结果:与花生/牛奶为基础的涂抹酱计划相比,接受谷物/坚果/豆科植物为基础的饼干组的儿童年龄更小(31 和33比39 个月,p=0.04),在参加研究时虽然轻度虚弱者高些(WHZ<-2 分别为:45%和39%比21%,p=0.114),但恢复率更高(84%和79%比62%,p=0.086),对方便食品的高使用频率(86%和84%比45%,p<0.001)其依从性>80%。多因素logistic 回归分析显示:高依从性,重增加与饼干的消费呈正相关(与花生/牛奶为基础的涂抹酱相比,r=0.188,p=0.051),并且与接受谷物/坚果/豆科植物为基础的饼干和花生/牛奶为基础的涂抹酱组相比,接受谷物/坚果/豆科植物为基础的饼干加上营养教育组的体重增加最高。结论:本地生产的方便食品饼干或涂抹酱在轻中度虚弱儿童的恢复中效果相似。
关键词:强化的方便食品、补充喂养、轻中度虚弱儿童、体重增加、项目依从性

 

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Factors associated with not using antenatal iron/folic acid supplements in Indonesia: the 2002/2003 and 2007 Indonesia Demographic and Health Survey
CHRISTIANA RIALINE TITALEY AND MICHAEL JOHN DIBLEY
Background: This analysis examined factors associated with non-use of antenatal iron/folic acid supplements in Indonesia. Methods: Data from the 2002/2003 and 2007 Indonesia Demographic and Health Surveys (IDHS) were used, providing survival information for 26,591 most recent deliveries over the five-year period prior to each survey. The main outcome variable was non-use of iron/folic acid supplements. Using logistic regression, we examined the role of external environment, predisposing, enabling, need factors, and previous utilization of other maternal care services in non-use of antenatal iron/folic acid supplements. Results: Mothers from outer Java-Bali Region and rural areas (OR=1.73, 95% CI: 1.48-2.03) had increased odds for not using antenatal iron/folic acid supplements. The likelihood for not using the supplements increased with the reduction of household wealth index and parental education. The odds increased amongst mothers with low autonomy on her own health care (OR=1.24, 95% CI: 1.04-1.49), high birth-rank infants, mothers with low knowledge of obstetric complications and low exposure to mass media. Enabling factors associated with increased odds for non-use of iron/folic acid supplements included mothers reporting money to pay health services (OR=1.28, 95% CI: 1.13-1.44) and distance to health services (OR=1.20, 95% CI: 1.02-1.40) were major problems. Our study demonstrated the importance of antenatal care as a distribution channel of the supplements. Conclusions: Increasing community awareness, coverage and access to health services along with strengthening counselling sessions during antenatal care and community participation in health programs are necessary to improve the uptake of iron/folic acid supplements, to increase infant survival in Indonesia.
Key Words: iron/folic acid supplements, antenatal, demographic and health survey, Indonesia
 

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在印度尼西亚产前未补充铁/叶酸的相关因素:2002、2003 和2007 印度尼西亚人口与健康普查
背景:本研究分析了印度尼西亚产前未补充铁/叶酸的相关因素。方法:本研究使用了2002、2003 和2007 年印度尼西亚人口与健康普查(IDHS)数据,采集了每次普查前近5 年26591 位妇女生育资料,其中主要的相关变量就是没有补充铁/叶酸。我们使用Logistic 回归分析,研究一些外部环境的作用、诱发、启用、需要因素,以及使用其他孕产妇保健服务对产前未补充铁/叶酸的人群的影响。结果:Java-巴厘地区以外以及农村地区有更多未补充铁/叶酸的母亲(OR=1.73, 95% CI: 1.48-2.03)。不服用这些补充剂的可能性随着家庭财富指数和父母受教育程度降低而增高。对于那些很少主动关注自身健康(OR=1.24, 95% CI: 1.04-1.49)、生产过多胎经产妇、对产科并发症知识低以及很少接触大众媒体的母亲,其不服用补充剂的几率升高。影响产前不补充铁/叶酸的主观因素主要有去做产前检查的费用(OR=1.28, 95% CI: 1.13-1.44)和与产前检查机构的距离(OR=1.20, 95% CI: 1.02-1.40)。我们的研究说明产前护理作为一个非常重要的补充剂的分配渠道。结论:提高社区意识,增加健康服务的覆盖率、在孕期护理期间加强宣传指导、组织社区参与健康计划,对提高铁/叶酸补充剂的摄入、增加印度尼西亚婴儿存活率将是非常必要的。
关键词:铁/叶酸补充剂、产前、人口和健康调查、印度尼西亚

 

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Trying to lose weight among non-overweight university students from 22 low, middle and emerging economy countries
KARL PELTZER AND SUPA PENGPID

The aim of this study was to assess the prevalence of trying to lose weight among non-overweight in university students and its sociodemographic and behavioural factors from 22 low and middle income and emerging economy countries. In a cross-sectional survey we took anthropometric measurements and used a self-administered questionnaire among 15997 undergraduate university students (mean age 20.8, Standard deviation=2.8, age range of 16-30 years) from 22 universities in 22 countries. Body mass index (BMI) was used for weight status. Results indicate that 27.1% non-overweight students were trying to lose weight, 34.6% among women and 16.5% among men. Among underweight or normal weight students, 19.0% perceived themselves to be overweight, 11.3% were dieting to lose weight, and 53.5% considered to lose weight of high importance. Multivariate logistic regression found that being female, coming from a low income country, the perception of being overweight, high importance of losing weight, dieting to lose weight, trying to eat fibre, and avoiding foods with fat and cholesterol were associated with trying to lose weight in non-overweight university students. The study found a high prevalence of weight control practices and several specific risk factors were identified that can be utilized in interventions to target unhealthy weight control measures.
Key Words: trying to lose weight, non-overweight, behavioral factors, university students, 22 countries

 

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来自中低新兴经济体国家的非超重大学生试图减肥
本研究的目的是评估来自22 个中低新兴经济体国家的非超重大学生试图减肥的发生率和引起他的社会人口和行为因素。在这个横断面调查中,我们测量了来自22 个国家22 所大学的15,997 名本科生(平均年龄20.8 岁,标准差为2.8,年龄范围为16-30 岁)的人体指标,每个志愿者填写了问卷。用体质指数(BMI)评估体重状况。结果显示27.1%的非超重学生在试图减肥,其中女生有34.6%,男生有16.5%。在低体重或正常体重的学生中,19.0%的人认为自己超重,11.3%的人在节食减肥,53.5%的人认为减肥很重要。多重logistic回归分析发现:来自低收入国家的女性、认为自己超重、减肥很重要、节食减肥、想要吃膳食纤维而避免吃含脂肪和胆固醇的食物与非超重大学生试图减肥有关。本研究发现确定了体重控制的做法和几个具体风险因素的高发生率,这个结果可用于对目标不健康体重控制措施的干预。
关键词:试图减肥、非超重、行为因素、大学生、22 个国家

 

 

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Effects of different parenteral nutrition infusions in a patient with short bowel syndrome
CHIA-CHEE WENG AND YUN CHEN

In this case study, we demonstrate the effects of different lipid emulsions on liver function in a 52-year-old woman with short bowel syndrome who was totally dependent on parenteral nutrition. Over a 13-month period after small bowel resection and jejunostomy, we followed the patient’s plasma triglycerides and liver enzyme levels as well as body weight and discomfort levels. During the first 3 months when parenteral nutrition including a lipid emulsion containing 50% soybean oil/50% medium-chain triglyerides was administered daily, the patient reported feeling unwell (experiencing dizziness and palpitations) and her triglycerides and liver enzyme levels rose to 366 mg/dL and 145 U/L (alanine aminotransferase [ALT]), respectively; these levels recovered when this emulsion was discontinued. For the following 9 months, an emulsion containing 80% olive oil and 20% soybean oil was administered, and the patient’s triglycerides (182 mg/dL) did not increase to abnormal levels and liver enzyme levels were only mildly elevated (109 U/L). The patient felt well and her body weight increased from 51 kg to 55 kg during this period. These results suggest that parenteral nutrition with a reduced soybean oil content may better preserve liver function in patients with short bowel syndrome.
Key Words: lipid emulsion, parenteral nutrition, short bowel syndrome, abnormal liver function, hypertriglyceridemia

 

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不同肠外营养输液对一位短腸综合症病患的影響
本篇報告一位52 歲因罹患短腸症综合症需完全依賴靜脈營養治療的女性,因接受不同成分比例的脂肪製劑导致肝功能不同的變化。在小腸切除與空腸造口後十三個月期間,我們追蹤病患的血中甘油三酯、肝臟酶水平、體重與臨床症狀。患者於小腸切除後前三個月初期使用的全靜脈脂肪乳劑成分比例為50%大豆油及50%中鏈脂肪酸,病人表示有心悸及頭暈的感覺,病人有肝功能異常及高甘油三酯血症,血清升至336 mg/dL,谷丙氨酸轉移酶(GPT)為145 U/L。在中止脂肪乳劑後,這些参数均得到改善。爾後九個月,我們將全靜脈營養脂肪乳劑比例改為20%大豆油及80%橄欖油,病人表示無心悸及頭暈的感覺,血清甘油三酯降為182 mg/dL,谷丙轉移酶(GPT)為109 U/L,體重由51 公斤增至55 公斤。本研究結果表明降低全靜脈營養中脂肪乳劑裡大豆油的比例,對病人的肝功能有好的影響。
关键词:脂肪乳劑、靜脈營養、短腸症、肝功能異常、高三酸甘油脂血症

 

Last Updated: March 2015