Oral nutritional supplements in patients with cystic fibrosis: research results
- 作者: Zarubina V.V.1, Vysokolova O.V.1, Mukhina M.A.1, Yakushina E.E.1, Kekeeva Т.N.1, Vitkovskaya I.P.2,3
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隶属关系:
- Morozov Children's Municipal Clinical Hospital
- Russian Research Institute of Health
- The Russian National Research Medical University named after N.I. Pirogov
- 期: 卷 30, 编号 6 (2024)
- 页面: 604-615
- 栏目: Original Research Articles
- URL: https://bakhtiniada.ru/0869-2106/article/view/292637
- DOI: https://doi.org/10.17816/medjrf636590
- ID: 292637
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详细
BACKGROUND: The nutritional status of patients with cystic fibrosis significantly affects their survival and the function of all organs, particularly the lungs. Due to increased protein and energy needs, these patients often require high-calorie and high-protein oral nutritional supplements (ONS).
AIM: To assess the tolerability, efficacy, and safety of Fresubin Protein® powder, a protein module.
MATERIALS AND METHODS: The data of 14 patients with mixed form of cystic fibrosis and nutritional deficiencies, aged between 6 and 16 years, were analyzed. Five patients received Fresubin Protein® powder as monotherapy (Group 1), four patients received the same therapeutic food together with emulsion of medium-chain triglycerides (Group 2), and five patients received ONS balanced in protein, fat, and carbohydrates (control group). The dynamics between percentile and Z-Scores of body mass index (BMI) at the beginning and at the end of the study period (day 180±2) were used as the main efficacy parameter of the investigated food. Body fat and lean body mass were assessed by caliperometry as additional efficacy parameters.
RESULTS: All patients showed an increase in Z-Score and BMI percentile from baseline while taking Fresubin Protein® powder both as monotherapy and in combination with medium-chain triglyceride emulsion. There were no statistically significant differences from the control group (p >0.05). However, Group 1 (100% of patients) demonstrated positive changes in muscle mass gain, as evidenced by caliperometry data, which was statistically significant (p <0.05) compared with the control group (20%). In Group 2, muscle gain was observed in 75% of the patients (p >0.05).
CONCLUSION: These findings suggest that protein-enriched ONS not only increase BMI but also contribute to muscle mass gain in patients with cystic fibrosis. New therapeutic approaches are needed, such as the inclusion of high-protein ONS in the diet to prevent muscle mass loss, along with the monitoring of body composition to improve control of disease progression.
作者简介
Vers Zarubina
Morozov Children's Municipal Clinical Hospital
编辑信件的主要联系方式.
Email: vv.zarubina@gmail.com
ORCID iD: 0000-0002-9724-7653
SPIN 代码: 5364-9263
俄罗斯联邦, Moscow
Olga Vysokolova
Morozov Children's Municipal Clinical Hospital
Email: opopova@morozdgkb.ru
ORCID iD: 0000-0003-4155-2226
SPIN 代码: 1632-7821
俄罗斯联邦, Moscow
Mariya Mukhina
Morozov Children's Municipal Clinical Hospital
Email: mariemuch@yandex.ru
ORCID iD: 0000-0002-8329-386X
SPIN 代码: 8391-1228
俄罗斯联邦, Moscow
Elena Yakushina
Morozov Children's Municipal Clinical Hospital
Email: e.e.yakushina@gmail.com
ORCID iD: 0000-0001-7090-0395
SPIN 代码: 2942-1154
俄罗斯联邦, Moscow
Тatiana Kekeeva
Morozov Children's Municipal Clinical Hospital
Email: kekeeva.genetic@gmail.com
ORCID iD: 0000-0002-4986-5748
SPIN 代码: 5818-1395
俄罗斯联邦, Moscow
Irina Vitkovskaya
Russian Research Institute of Health; The Russian National Research Medical University named after N.I. Pirogov
Email: vip-dzm@mail.ru
ORCID iD: 0000-0002-0740-1558
SPIN 代码: 2970-0361
MD, Cand. Sci. (Medicine), Associate Professor
俄罗斯联邦, Moscow; Moscow参考
- Union of Paediatricians of Russia, Association of Medical Geneticists, Russian Respiratory Society, Russian Transplant Society, Association of Children's Doctors of the Moscow Region. Cystic fibrosis (cystic fibrosis): clinical recommendations. In: Rubric clinical guidelines [Internet]. Ministry of Health of the Russian Federation; 2021 [cited 03 Sep 2021]. Available from: https://cr.minzdrav.gov.ru/recomend/372_2 (In Russ.)
- Kondratieva EI, Kashirskaya NYu, Kapranov NI, editors. National consensus “Cystic fibrosis: definition, diagnostic criteria, therapy”. 2nd ed. Moscow: Boroges Company; 2018, 356 p. (In Russ.)
- Kapranov NI, Kashirskaya NY, Kondratieva EI, editors. Cystic fibrosis. Edition 2nd, revised and supplemented. Moscow: MEDPRACTICA-M; 2021. (In Russ.)
- Sherman VD, Kondratieva EI, Voronkova AY, et al. Influence of neonatal screening for cystic fibrosis by the example of patients of the Moscow region. Medical Council. 2017;(18):124–128. EDN: ZQTKQN doi: 10.21518/2079-701X-2017-18-124-128
- Vitkovskaya IP, Abramov SI, Zelenova OV. Clinical and economic justification for the inclusion of new enteral mixtures in the list of specialized products therapeutic nutrition for disabled children diagnosed with cystic fibrosis. Sovremennye problemy zdravoohranenija i medicinskoj statistiki. 2023;(1):435–449. EDN: MILLZZ doi: 10.24412/2312-2935-2023-1-435-449
- Turck D, Braegger CP, Colombo C, et al. ESPEN-ESPGHAN-ECFS guidelines on nutrition care for infants, children, and adults with cystic fibrosis. Clin Nutr. 2016;35:557–77. doi: 10.1016/j.clnu.2016.03.004
- Li L, Somerset S. Digestive system dysfunction in cystic fibrosis: challenges for nutrition therapy. Dig Liver Dis. 2014;46:865–874. doi: 10.1016/j.dld.2014.06.011
- Calella P, Valerio G, Brodlie M, et al. Cystic fibrosis, body composition and health outcomes: a systematic review. Nutrition. 2018;55-56:131–139. doi: 10.1016/j.nut.2018.03.052
- Culhane S, George C, Pearo B, Spoede E. Malnutrition in cystic fibrosis: a review. Nutr Clin Pract. 2013;28(6):676–683. doi: 10.1177/0884533613507086
- Engelen MP, Com G, Deutz NEP. Protein is an important but undervalued macronutrient in the nutritional care of patients with cystic fibrosis. Curr Opin Clin Nutr Metab Care. 2014;17(6):515–520. doi: 10.1097/MCO.0000000000000100
- Geukers VG, Oudshoorn JH, Taminiau JA, et al. Short-term protein intake and stimulation of protein synthesis in stunted children with cystic fibrosis. Am J Clin Nutr. 2005;81(3):605–610. doi: 10.1093/ajcn/81.3.605
- Stephenson AL, Mannik LA, Walsh S, et al. Longitudinal trends in nutritional status and the relation between lung function and BMI in cystic fibrosis: a population-based cohort study. Am J Clin Nutr. 2013;97(4):872–877. doi: 10.3945/ajcn.112.051409
- Waterlow JC. Protein-energy malnutrition, 2nd edition. London: Edward Arnold, 1992. 407 p. ISBN-10: 0340600608, ISBN-13: 978-0340600603
- WHO Guideline: Updates on the management of severe acute malnutrition in infants and children. Geneva: World Health Organization; 2013.
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