Nutritional assessment and influencing factors in children with Duchenne muscular dystrophy:a relevant study
LI Li1,MU Ying2, SUN Yanfeng3, LI Hui1
1. Department of Nutrition, 3. Department of Paediatrics, General Hospital of Armed Police Forces, Beijing 100039, China; 2. Department of Nutrition, 302 Military Hospital of China,Beijing 100032, China
Abstract:Objective To investigate the relationship between nutritional status and influencing factors of children with Duchenne muscular dystrophy (DMD), providing the basis for nutritional and integrated caring of this disease. Methods The study included 154 children with DMD who received treatments at the Department of Neurology of the General Hospital of the Chinese People’s Armed Police Force along with outpatient clinics from 2013 through 2014. Z-scores (WAZ, HAZ, WHZ and BAZ) were calculated, ttest and Spearman rank correlation analysis were conducted between Z-scores and influencing factors. Results In Z-scores, means of both WHZ and BAZ were positive, while those of both WAZ and HAZ were negative. Growth retardation was present at the early stage of walking (<9 year-old); there was a high incidence of low body weight and growth retardation (P<0.05) till the late stage of walking (≥9 year-old). For children with DMD, incidence rates of low body weight, growth retardation, emaciation and obesity were 4.6%, 20.1%, 3.9% and 13.0%, respectively. Especially, children at the early stage of walking had a high incidence of obesity (16.9%), while the incidence of growth retardation was up to 30.8% in those at the late stage of walking. Z-scores correlated with some influencing factors, WAZ and HAZ and family monthly income was positively related among them (P<0.05). Conclusions The nutritional status in children with DMD is unoptimistic with Z-scores at a low level; positive measures should be taken to allow clinicians and children’s parents to improve the knowledge of the nutritional therapy for DMD, providing a good basis for sequential treatment of this disease.
李丽, 牟瑛, 孙岩峰, 李卉. Duchenne型肌营养不良患儿营养状况及其影响因素的相关性[J]. 武警医学, 2015, 26(5): 460-462.
LI Li,MU Ying, SUN Yanfeng, LI Hui. Nutritional assessment and influencing factors in children with Duchenne muscular dystrophy:a relevant study. Med. J. Chin. Peop. Armed Poli. Forc., 2015, 26(5): 460-462.
Helderman Enden A T,Madan K,Breuning M H,et al. An urgent need for a change in policy revealed by a study on prenatal testing for Duchenne muscular dystrophy[J].Eur J Hum Genet,2012,2:123.
Moxley R T, Ashwal S, Pandya S, et al. Practice parameter: corticosteroid treatment of Duchenne dystrophy. Report of the Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society [J]. Neurol, 2005, 64(1):13-20.
[4]
Manzur A Y, Kuntzer T, Pike M, et al. Glucocorticoid corticosteroids for Duchenne muscular dystrophy [J]. Cochrane Database Syst Rev, 2008, 23(1): 3725.
[5]
Manzur A Y, Muntoni F. Diagnosis and new treatments in muscular dystrophies [J]. J Neurol Neurosurg Psychiatry, 2009, 80(7): 706-714.
[6]
Bushby K, Finkel R, Birnkrant D J, et al. Diagnosis and management of Duchenne muscular dystrophy, part 2: implemenetation of multidisciplinary care [J]. Lancet Neurol, 2010, 9 (2): 177-189.
[7]
Bushby K, Finkel R, Birnkrant D J, et al. Diagnosis and management of Duchenne muscular dystrophy, part 1: diagnosis, and pharmacological and psychosocial management [J]. lancet Neurol, 2010, 9(1): 77-93.
[8]
Moxley R T, Pandya S, Ciafaloni E, et al. Change in natural history of Duchenne muscular dystrophy with long-term corticosteroid treatment: Implications for management [J]. J Child Neurol, 2010, 25(9): 1116-1129.
[9]
李作汗,张 平.神经肌肉疾病的临床与病理[M]. 北京:人民卫生出版社,2007:11-90.
[10]
董为伟. 神经系统疾病治疗学[M]. 北京:科学出版社,2007:723.
[11]
Rodriguez Oliveros G, Haines J, Ortega Altamirano D, et al. Obesity determinants in Mexican preschool children: parental perceptions and practices related to feeding and physical activity [J]. Arch Med Res, 2011, 42(6): 532-539.