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Estado nutricional em crianças e adolescentes com fibrose quística
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Advisor(s)
Abstract(s)
Introdução: A Fibrose Quística (FQ) é a doença hereditária autossómica com risco de vida mais comum na Europa onde atualmente mais de 44.000 casos estão registados. É fortemente associada a um aumento das necessidades de energia e nutrientes e existe uma forte associação entre o estado nutricional e os resultados clínicos. Assim, o presente estudo tem por objetivo, numa amostra em crianças e adolescentes com FQ, avaliar o estado nutricional e a adequação da ingestão nutricional comparando com as necessidades nutricionais preconizadas para a idade e situação clínica. Materiais e métodos: Estudo observacional, transversal e analítico. Foram recolhidos peso, altura, perímetro da cintura, prega cutânea tricipital (PCT) e prega cutânea subescapular (PCSE). Foram calculadas e classificadas razão cintura/altura, PCT, percentagem de massa gorda (MG), Índice de Massa Gorda (IMG) e Índice de Massa Livre de Gordura (IMLG), e calculados z-scores. Foi recolhido e posteriormente quantificado o registo alimentar de 3 dias e também recolhidos dados demográficos, clínicos e bioquímicos, e foi aplicado o International Physical Activity Questionnaire (IPAQ). Resultados: Na classificação do z-score de Índice de Massa Corporal (IMC), 75% da amostra apresentava-se em eutrofia, já pela classificação do z-score peso/idade todos os analisados apresentaram-se com peso adequado para a idade e no z-score estatura/idade, 95% apresentaram-se com estatura adequada. Ao classificar a PCT, 45% da amostra encontrava-se abaixo e 55% acima do percentil 50 enquanto na classificação da MG, apresentaram valores adequados e pelo IMG apresentaram-se 35% acima ou igual ao z-score 0 enquanto o IMLG mostrou 60% acima ou igual ao z-score 0. Foi encontrada uma correlação entre o FEV1 (L) e o IMC, e outras correlações significativas. No que toca à ingestão de energia, com base nas guidelines europeias, 25% dos utentes estavam dentro da recomendação, enquanto pelas guidelines americanas, 55% estavam de acordo. Conclusão: Este estudo concluiu que na avaliação do estado nutricional do utente é preferível a utilização de IMC, porém também se deve avaliar a MLG e MG do indivíduo com FQ, visto que estes parâmetros podem estar alterados e serem mascarados com um IMC adequado. De reforçar que mesmo com IMC adequado, poderemos estar na presença de stunting, pelo que a altura/comprimento para a idade deve igualmente ser um parâmetro a valorizar. Também podese concluir o desafio que é se manter dentro dos valores recomendados pelas guidelines.
ABSTRACT: Introduction: Cystic Fibrosis (CF) is the most common life-threatening autosomal hereditary disease in Europe where currently more than 44.000 cases are registered. It is strongly associated with increased energy and nutrient requirements and there is a strong association between nutritional status and clinical outcomes. Therefore, the present study aims, in a sample of children and adolescents with CF, to evaluate the nutritional status and adequacy of nutritional intake compared to preconized nutritional requirements for the age and clinical situation. Materials and methods: Observational, cross-sectional, and analytical study. Weight, height, waist circumference, tricipital skinfold thickness (TSFT), and subscapular skinfold thickness (SSFT) were collected. Waist/height ratio, TSFT, percentage of fat mass (FM), Fat Mass Index (FMI), and Fat-Free Mass Index (FFMI) were calculated and classified, and z-scores were calculated. A 3-day food record was collected and subsequently quantified, as well as demographic, clinical, and biochemical data and the International Physical Activity Questionnaire (IPAQ) was applied. Results: In the Body Mass Index (BMI) z-score classification, 75% of the sample was eutrophic and in the weight/age z-score classification, all those analyzed presented themselves with adequate weight for their age, and in the height/age z-score, 95% showed adequate height. When classifying the TSFT, 45% of the sample was below and 55% above the 50th percentile while in the FM classification, they presented adequate values, and by the FMI they were 35% above or equal to z-score 0 while FFMI showed 60% above or equal to z-score 0. A correlation was found between FEV1 (L) and BMI, and other significant correlations. Regarding energy intake, based on European guidelines, 25% of the patients were within the recommendation, while according to American guidelines, 55% were in accordance. Conclusion: This study concluded that when evaluating the nutritional status of the patient, it is preferable to use BMI, however, the FFM and FM of the individual with CF must also be assessed, as these parameters may be altered and masked with an adequate BMI. It should be noted that even with adequate BMI, we may be in the presence of stunting, so height/length for age should also be a parameter to be valued. It can also be concluded that it is a challenge to remain within the values recommended by the guidelines.
ABSTRACT: Introduction: Cystic Fibrosis (CF) is the most common life-threatening autosomal hereditary disease in Europe where currently more than 44.000 cases are registered. It is strongly associated with increased energy and nutrient requirements and there is a strong association between nutritional status and clinical outcomes. Therefore, the present study aims, in a sample of children and adolescents with CF, to evaluate the nutritional status and adequacy of nutritional intake compared to preconized nutritional requirements for the age and clinical situation. Materials and methods: Observational, cross-sectional, and analytical study. Weight, height, waist circumference, tricipital skinfold thickness (TSFT), and subscapular skinfold thickness (SSFT) were collected. Waist/height ratio, TSFT, percentage of fat mass (FM), Fat Mass Index (FMI), and Fat-Free Mass Index (FFMI) were calculated and classified, and z-scores were calculated. A 3-day food record was collected and subsequently quantified, as well as demographic, clinical, and biochemical data and the International Physical Activity Questionnaire (IPAQ) was applied. Results: In the Body Mass Index (BMI) z-score classification, 75% of the sample was eutrophic and in the weight/age z-score classification, all those analyzed presented themselves with adequate weight for their age, and in the height/age z-score, 95% showed adequate height. When classifying the TSFT, 45% of the sample was below and 55% above the 50th percentile while in the FM classification, they presented adequate values, and by the FMI they were 35% above or equal to z-score 0 while FFMI showed 60% above or equal to z-score 0. A correlation was found between FEV1 (L) and BMI, and other significant correlations. Regarding energy intake, based on European guidelines, 25% of the patients were within the recommendation, while according to American guidelines, 55% were in accordance. Conclusion: This study concluded that when evaluating the nutritional status of the patient, it is preferable to use BMI, however, the FFM and FM of the individual with CF must also be assessed, as these parameters may be altered and masked with an adequate BMI. It should be noted that even with adequate BMI, we may be in the presence of stunting, so height/length for age should also be a parameter to be valued. It can also be concluded that it is a challenge to remain within the values recommended by the guidelines.
Description
Mestrado em Nutrição Clínica
Keywords
Nutrição clínica Fibrose quística Saúde infantil Estado nutricional Ingestão nutricional Clinical nutrition Cystic fibrosis Pediatrics Nutritional status Nutritional intake MNC