背景:对于骨骼健康的人和骨质疏松症患者,建议采用富含钙和蛋白质的均衡饮食,但它也可能是重要的罕见骨病(RBD)。关于RBD和饮食的数据很少。因此,这项研究的目的是评估RBD患者的营养行为。
方法:这种单中心,横截面,基于问卷调查的研究评估了RBD患者的营养行为(X连锁低磷酸盐血症(XLH),成骨不全症(OI),低磷酸盐血症(HPP)),骨质疏松症(OPO)患者和健康对照(CTRL)。营养问卷包括来自七个营养领域的25个问题。通过年龄调整单变量协方差分析(ANCOVA)评估社会经济因素与BMI之间的关联。
结果:50例RBD患者(17OI,17HPP,16XLH;平均年龄48.8±15.9,26.0%男性,平均BMI26.2±5.6),51岁,OPO(平均年龄66.6±10.0,男性9.8%,平均BMI24.2±3.9)和52CTRL(平均年龄50.8±16.3,26.9%男性,平均BMI26.4±4.7)参加。二十六(52.0%)RBD,17(33.4%)OPO和24(46.1%)CTRL根据BMI超重或肥胖。只有少数RBD,OPO和CTRL每天至少摄入三份牛奶或奶制品(17.3%RBD,15.6%OPO,11.6%CTRL,p=0.453)。总的来说,在三个亚组之间观察到相似的营养行为.然而,咖啡因摄入量存在显著差异(p=0.016),水果/蔬菜汁消费量(p=0.034),每周鱼的份量(p=0.044),每周的高脂肪膳食(p=0.015)和咸味零食的消费(p=0.001)。
结论:营养咨询,控制BMI并确保足够的钙和蛋白质摄入对于骨质疏松症患者以及罕见的骨骼疾病至关重要。维生素D似乎没有足够的饮食供应,因此,骨骼疾病患者应考虑补充。
BACKGROUND: A balanced diet rich in calcium and protein is recommended for bone-healthy people and osteoporosis patients, but it may also be important for rare bone disease (RBD). Little data is available on RBD and diet. Therefore, the aim of this study was to evaluate the nutritional behavior of patients with RBD.
METHODS: This single-center, cross-sectional, questionnaire-based study assessed the nutritional behavior of RBD patients (X-linked hypophosphatemia (XLH), osteogenesis imperfecta (OI),
hypophosphatasia (HPP)), osteoporosis (OPO) patients and healthy controls (CTRL). The nutritional questionnaire comprised 25 questions from seven nutritional areas. The associations between socioeconomic factors and BMI were assessed by age-adjusted univariate analysis of covariance (ANCOVA).
RESULTS: Fifty patients with RBD (17 OI, 17 HPP, 16 XLH; mean age of 48.8 ± 15.9, 26.0% male, mean BMI 26.2 ± 5.6), 51 with OPO (mean age 66.6 ± 10.0, 9.8% male, mean BMI 24.2 ± 3.9) and 52 CTRL (mean age 50.8 ± 16.3, 26.9% male, mean BMI 26.4 ± 4.7) participated. Twenty-six (52.0%) RBD, 17 (33.4%) OPO and 24 (46.1%) CTRL were overweight or obese according to BMI. Only a minority of RBD, OPO and CTRL had a daily intake of at least three portions of milk or milk products (17.3% RBD, 15.6% OPO, 11.6% CTRL, p = 0.453). In general, similar nutritional behavior was observed between the three subgroups. However, significant differences were found in caffeine consumption (p = 0.016), fruit/vegetable juice consumption (p = 0.034), portions of fish per week (p = 0.044), high-fat meals per week (p = 0.015) and consumption of salty snacks (p = 0.001).
CONCLUSIONS: Nutritional counseling, controlling BMI and ensuring sufficient calcium and protein intake are crucial in patients with osteoporosis as well as in rare bone diseases. Vitamin D does not appear to be sufficiently supplied by the diet, and therefore supplementation should be considered in patients with bone diseases.