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Influence of TCF7L2 gene polymorphisms on the effectiveness of various variants of antihyperglycaemic therapy in patients with type 2 diabetes TCF7L2基因多态性对2型糖尿病患者各种抗高血糖治疗效果的影响
Q3 Medicine Pub Date : 2021-01-01 DOI: 10.20953/2224-5448-2021-2-11-20
О.V. Kondratyeva, K. Sharafetdinov, O. A. Plotnikova
Single nucleotide polymorphisms of the TCF7L2 gene demonstrate the strongest association with the risk of developing type 2 diabetes, linking its effects to changes in insulin secretion. The mechanism of action of hypoglycaemic drugs used in treatment of type 2 diabetes is, to a certain extent, related to their influence on the function of β-cells, which implies that variants of the TCF7L2 gene will affect the therapeutic effect of certain anti-hyperglycaemic drugs, including the variability in the effects of incretin-based therapy, and sulphonylurea derivatives. Along with the direct influence of the TCF7L2 gene on the function of β-cells, there is evidence of the effects of TCF7L2 gene polymorphism on the susceptibility to external risk factors associated with the development of type 2 diabetes, including the alimentary factors. Pharmacogenetic studies in diabetology have at present the greatest potential in terms of selection of the optimal comprehensive anti-hyperglycaemic therapy based on preliminary genetic testing, which might improve the outcomes of treatment and the prognosis for the course of type 2 diabetes, reducing the number of life-threatening complications. Key words: GPP-1 agonists, TCF7L2 gene, metformin, nutrition, type 2 diabetes, sulphonylureas
TCF7L2基因的单核苷酸多态性与患2型糖尿病的风险密切相关,将其影响与胰岛素分泌的变化联系起来。用于治疗2型糖尿病的降糖药物的作用机制在一定程度上与其对β细胞功能的影响有关,这意味着TCF7L2基因的变异会影响某些降糖药物的治疗效果,包括以肠促胰岛素为基础的治疗效果的变异性,以及磺脲类衍生物。随着TCF7L2基因对β-细胞功能的直接影响,有证据表明TCF7L2基因多态性对2型糖尿病发生相关的外部危险因素易感性的影响,包括饮食因素。目前,糖尿病学的药物遗传学研究在基于初步基因检测选择最佳综合抗高血糖疗法方面具有最大的潜力,这可能改善2型糖尿病的治疗结果和预后,减少危及生命的并发症的数量。关键词:GPP-1激动剂,TCF7L2基因,二甲双胍,营养,2型糖尿病,磺脲类药物
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引用次数: 1
Dietary specificity in women engaged in intellectual work with low physical activity 从事体力活动少的脑力劳动的妇女的饮食特异性
Q3 Medicine Pub Date : 2021-01-01 DOI: 10.20953/2224-5448-2021-1-5-13
Е.N. Lobykina, L. Proskuryakova
Objective. Unbalanced nutrition of women of different age is one of the risk factors for developing chronic non-infectious diseases at early working age. The aim of the work was to study the nutrition of working-age women living in a large industrial centre, whose work patterns are characterized by a low level of physical activity. Patients and methods. A retrospective cross-sectional study included 282 women with low physical activity: group 1 – 18–39-year-olds (n = 176), group 2 – 40 years and older (n = 108). The computer program «Analysis of the state of human nutrition» (version 1.2, Institute of Nutrition RAMS 2003–2005) assessed the actual nutrition. Inter-group comparison of parameters was performed using the Mann–Whitney (U) test with the Benjamini–Hochberg correction. Results. The calorific value of the diets exceeded the norms (in group 1 by 1.1 times, in group 2 by 1.6 times) due to consumption of proteins and fats. Cholesterol intake was reduced in both groups (by 0.6–0.9 times, respectively). The proportions of dietary mono- and disaccharides exceeded the norm by 2 and more times in both groups, deficiency of dietary fiber was found in group 1 – 26.5%, in group 2 – 45% of normal. In both groups, a higher intake of sodium (by 2–3.5 times) and phosphorus (by 1.4–2 times) was found. Group 1 had a lower intake of Ca (by 1.4 times), Mg (by 1.6 times), vitamins B1 (by 1.8 times), B2 (by 1.5 times) and PP (by 1.8 times). In group 2, mineral and vitamin intake was significantly higher but insufficient as well. Conclusion. Women's diets are imbalanced toward the excess of the total caloric intake, the amounts of consumed proteins and fats, sodium, potassium, phosphorus; insufficient intake of dietary fiber, Ca, Fe, and some vitamins, which is a serious risk factor for the development of chronic non-infectious diseases and should be taken into account in treatment and prevention programmes implemented at younger ages.
目标。不同年龄妇女营养不均衡是早期工作年龄发生慢性非传染性疾病的危险因素之一。这项工作的目的是研究生活在一个大型工业中心的工作年龄妇女的营养状况,这些妇女的工作模式的特点是体力活动水平低。患者和方法。一项回顾性横断面研究包括282名低体力活动的女性:1组- 18 - 39岁(n = 176), 2组- 40岁及以上(n = 108)。计算机程序“人类营养状况分析”(1.2版,营养研究所2003-2005)评估了实际营养。采用Mann-Whitney (U)检验和Benjamini-Hochberg校正进行组间参数比较。结果。由于蛋白质和脂肪的消耗,饮食的热值超过了标准(第一组1.1倍,第二组1.6倍)。两组的胆固醇摄入量都减少了(分别减少了0.6-0.9倍)。各组饲料中单糖和双糖的比例均超过正常值的2倍以上,1组和2组的膳食纤维分别不足正常值的26.5%和45%。在两组中,钠(2-3.5倍)和磷(1.4-2倍)的摄入量都较高。1组低钙(1.4倍)、低镁(1.6倍)、低维生素B1(1.8倍)、低维生素B2(1.5倍)、低维生素PP(1.8倍)。在第二组,矿物质和维生素的摄入量明显较高,但也不足。结论。妇女的饮食不平衡,总热量摄入过多,蛋白质和脂肪摄入过多,钠、钾、磷摄入过多;膳食纤维、钙、铁和一些维生素摄入不足,这是发展慢性非传染性疾病的一个严重危险因素,应在较年轻实施的治疗和预防方案中予以考虑。
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引用次数: 0
Diagnostic value of platelet count and platelet indices in assessing inflammatory bowel disease activity in children 血小板计数和血小板指数在评估儿童炎症性肠病活动性中的诊断价值
Q3 Medicine Pub Date : 2021-01-01 DOI: 10.20953/1727-5784-2021-3-26-36
E. Semikina, V. Tsvetkova, A. Potapov, A. Fisenko, E. A. Kopyl'tsova, S. Akulova, A. Surkov, M. Lokhmatov, T. N. Budkina, M. Vershinina
Objective. To analyze the connection between the complex of platelet indices in complete blood count test with the clinical and endoscopic activity scores for Crohn's disease (CD) and ulcerative colitis (UC) in pediatric patients and to determine their most informative threshold values. Patients and methods. In this study, 370 children aged 5 to 18 years with diagnosed CD (n = 150) and UC (n = 220) were examined. The clinical activity of UC was assessed according to PUCAI, CD – according to PCDAI; the assessment of endoscopic activity in children with UC was carried out according to UCEIS and CD – according to SES-CD. The study included platelet indices of 630 complete blood count tests (270 in patients with CD and 360 in patients with UC): platelet count (PLT), mean platelet volume (MPV), platelet large cell ratio (P-LCR) and platelet distribution width (PDW). Results. Increased platelet count and decreased platelet indices were noted as the clinical and endoscopic activity of CD and UC in children increased. A positive correlation between the clinical and endoscopic activity indices in inflammatory bowel diseases and platelet count and negative correlations with platelet indices were revealed. ROC analysis showed that the informative value of platelet indices in assessing the endoscopic activity of CD and UC is higher than in assessing the clinical activity. The optimal threshold values for platelet count (cut-off) for determining the endoscopic activity of CD and UC were 340 × 109/L and 350 × 109/L (Se 77%, Sp 69% and Se 63%, Sp 67%, respectively). The specificity of determing the endoscopic activity of 99% was obtained for platelet count of 459 × 109/L and 390 × 109/L for CD and UC, respectively. In children with CD, the indicators MPV <7.8 fL, PDW <7.25 fL, P-LCR <15.2% characterized the presence of endoscopic disease activity with 99% specificity; in children with UC, the specificity of determining the endoscopic activity of 99% was obtained for MPV <9.25 fL, PDW <9.85 fL, P-LCR <17.5%. Conclusion. An increase in platelet count and a decrease in platelet indices (MPV, PDW and P-LCR) can be surrogate markers of endoscopic activity of these diseases. The established threshold values will improve the accuracy of diagnosing the activity of inflammatory bowel diseases in children. Key words: Crohn's disease, ulcerative colitis, platelets, platelet indices, clinical activity, endoscopic activity
目标。分析全血细胞计数试验中血小板指数复合体与儿科患者克罗恩病(CD)和溃疡性结肠炎(UC)的临床和内镜活动性评分之间的关系,并确定其最具信息量的阈值。患者和方法。在这项研究中,370名5至18岁的诊断为CD (n = 150)和UC (n = 220)的儿童进行了检查。UC临床活动性按PUCAI评估,CD -按PCDAI评估;根据UCEIS和CD -根据SES-CD对UC患儿的内镜活动进行评估。研究包括630项全血细胞计数(CD患者270项,UC患者360项)的血小板指标:血小板计数(PLT)、平均血小板体积(MPV)、血小板大细胞比(P-LCR)和血小板分布宽度(PDW)。结果。随着儿童CD和UC的临床和内镜活动的增加,血小板计数增加,血小板指数下降。炎症性肠病的临床和内镜活动指数与血小板计数呈正相关,与血小板指数呈负相关。ROC分析显示,血小板指数在评估CD和UC的内镜活动性方面的信息价值高于评估临床活动性。用于判断CD和UC内镜下活动性的血小板计数最佳阈值(截止值)分别为340 × 109/L和350 × 109/L (Se为77%,Sp为69%,Se为63%,Sp为67%)。对于血小板计数分别为459 × 109/L和390 × 109/L的CD和UC,确定内镜下活性的特异性为99%。在CD患儿中,MPV <7.8 fL, PDW <7.25 fL, P-LCR <15.2%表征内镜下疾病活动性,特异性为99%;在UC患儿中,当MPV <9.25 fL, PDW <9.85 fL, P-LCR <17.5%时,确定内镜下活动的特异性为99%。结论。血小板计数的增加和血小板指数(MPV、PDW和P-LCR)的下降可以作为这些疾病内镜下活动的替代标志物。建立的阈值将提高诊断儿童炎症性肠病活动性的准确性。关键词:克罗恩病,溃疡性结肠炎,血小板,血小板指数,临床活动性,内镜活动性
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引用次数: 0
Current state of celiac disease diagnosis in Uzbekistan: problems and solutions 乌兹别克斯坦乳糜泻诊断现状:问题和解决办法
Q3 Medicine Pub Date : 2021-01-01 DOI: 10.20953/1727-5784-2021-4-15-22
A. Kamilova, G. Azizova, S. Geller
Objective. To study the state of diagnosis, clinical manifestation and laboratory changes in children with celiac disease in the Republic of Uzbekistan. Patients and methods. The article presents a description of 64 newly diagnosed cases of celiac disease registered in the Republican Specialized Scientific and Practical Medical Center of Pediatrics. Celiac disease was diagnosed according to the ESPGHAN criteria. Results. Out of 64 patients, celiac disease was more frequently diagnosed among girls (69.6%), the median age at diagnosis was 5.3 ± 0.6 years. Classic symptoms were observed in 46 (71.9%) patients, the number of patients with extraintestinal manifestations was 18 (28.1%). In classical celiac disease, the most common intestinal symptoms were bloating, diarrhea, and severe protein-energy malnutrition (p ≤ 0.05; p ≤ 0.0001). Among the patients with extraintestinal manifestations, there were more often children with subnanism (p ≤ 0.05). Hemoglobin and calcium levels decreased with the same frequency in atypical and typical forms of celiac disease; there was an increase in the level of alkaline phosphatase in both groups, but higher amounts were found in typical forms of the disease. The majority of patients had a histological study of the intestinal mucosa according to Marsh III, most commonly – IIIc (total villous atrophy). Conclusion. The diagnosis of celiac disease in children living in Uzbekistan is established with a considerable delay. Most patients have classic symptoms accompanied by intestinal manifestations. It is essential to be alert to the diagnosis of celiac disease in patients with extraintestinal manifestations in the absence of diarrhea. In this regard, it is necessary to raise doctors’ awareness of the diagnosis of atypical forms of the disease, as well as to improve their knowledge about different manifestations of celiac disease. Key words: celiac disease, extraintestinal manifestations, children, diagnosis
目标。目的了解乌兹别克斯坦儿童乳糜泻的诊断、临床表现及实验室检查结果。患者和方法。本文介绍了在共和党儿科专业科学与实用医学中心登记的64例新诊断的乳糜泻病例的描述。根据ESPGHAN标准诊断乳糜泻。结果。在64例患者中,乳糜泻在女孩中更常见(69.6%),诊断时的中位年龄为5.3±0.6岁。典型症状46例(71.9%),肠外表现18例(28.1%)。经典乳糜泻最常见的肠道症状是腹胀、腹泻和严重的蛋白质能量营养不良(p≤0.05;P≤0.0001)。在有肠外表现的患者中,以亚胃炎患儿较多(p≤0.05)。在典型和非典型乳糜泻中,血红蛋白和钙水平下降的频率相同;两组患者的碱性磷酸酶水平都有所增加,但在典型的疾病类型中发现的水平更高。大多数患者根据Marsh III进行肠黏膜组织学检查,最常见的是- IIIc(全绒毛萎缩)。结论。对生活在乌兹别克斯坦的儿童进行乳糜泻诊断的时间相当晚。大多数患者有典型症状并伴有肠道表现。在没有腹泻的情况下,有肠外表现的患者必须警惕乳糜泻的诊断。因此,有必要提高医生对乳糜泻非典型形式诊断的认识,提高对乳糜泻不同表现的认识。关键词:乳糜泻,肠外表现,儿童,诊断
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引用次数: 5
Vitamin D deficiency: a pandemic of the 21st century. Problems of standardization of diagnosis of vitamin D deficiency 维生素D缺乏症:21世纪的流行病。维生素D缺乏症标准化诊断的问题
Q3 Medicine Pub Date : 2021-01-01 DOI: 10.20953/2224-5448-2021-1-33-43
E. V. Kochneva, S. Kalinchenko, D. V. Makharoblishvili
Vitamin D deficiency is a noninfectious pandemic of the 21st century. Vitamin D, apart from its role in phosphorus-calcium metabolism, is vital for functioning of all organs and systems, and its deficiency is a risk factor of developing aging-associated extraskeletal diseases. Vitamin D deficiency is a multifactor process related to a decreased synthesis of endogenous cholecalcipherol, insufficient intake of exogenous vitamin D and its disordered metabolism. Improvement of the effectiveness of therapeutic and preventive measures for management of vitamin D deficiency is impossible without accurate laboratory diagnosis. Immunochemical methods (radioactive, enzymatic and chemiluminescent) overestimate the 25(ОН)D levels, a benchmark test for vitamin D status assessment is a high performance liquid chromatography tandem–mass spectrometry. In order to reduce the risk of socially significant diseases the adequate 25(ОН)D levels should be not less than 40 ng/mL (100 nmol/L). Key words: vitamin D, vitamin D deficiency, liquid chromatography tandem–mass spectrometry
维生素D缺乏症是21世纪的一种非传染性流行病。维生素D除了在磷钙代谢中起作用外,对所有器官和系统的功能都至关重要,缺乏维生素D是发生与衰老相关的骨骼外疾病的一个危险因素。维生素D缺乏是一个多因素过程,与内源性胆钙化酚合成减少、外源性维生素D摄入不足及其代谢紊乱有关。如果没有准确的实验室诊断,就不可能提高维生素D缺乏症的治疗和预防措施的有效性。免疫化学方法(放射性,酶和化学发光)高估25(ОН)D水平,维生素D状态评估的基准测试是高效液相色谱串联质谱法。为了降低社会重大疾病的风险,适当的25(ОН)D水平应不低于40 ng/mL (100 nmol/L)。关键词:维生素D,维生素D缺乏症,液相色谱串联质谱法
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引用次数: 0
Xerostomia as a cause of impaired digestion 口干症是消化不良的原因
Q3 Medicine Pub Date : 2021-01-01 DOI: 10.20953/2224-5448-2021-2-56-58
V. Afanasyev, S. Kalinchenko, N. Vinokurov, L. Vorslov, A. Fomin
Xerostomia (dryness in the mouth) arises due to inadequate saliva secretion associated with various conditions of the body and, in particular, of the salivary glands. The diagnosis and treatment of xerostomia does not receive due attention in the Russian Federation, whereas saliva forms the food bolus and is responsible for the first stage of food digestion. The causes of xerostomia are varied, and therefore its treatment meets with considerable difficulties. One of the methods of treating xerostomia is replacement therapy, but it is rarely and insufficiently administered in RF. The authors give a detailed description of the clinical picture of a dry mouth in 80 patients, who received a multicomponent formulation «Xerostom » as substitution therapy. The study showed that the best results were obtained by using gel and spray. Key words:salivary glands, xerostomia, saliva substitutes
口干症(口腔干燥)是由于与身体的各种状况有关的唾液分泌不足而引起的,特别是唾液腺。在俄罗斯联邦,口干症的诊断和治疗没有得到应有的重视,而唾液形成食物丸,负责食物消化的第一阶段。口干症的原因是多种多样的,因此其治疗遇到了相当大的困难。治疗口干症的方法之一是替代疗法,但它很少和不充分的射频管理。作者详细描述了80名接受多组分制剂«Xerostom»替代疗法的患者的口腔干燥的临床表现。研究表明,凝胶法和喷雾法的效果最好。关键词:唾液腺,口干症,唾液代用品
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引用次数: 1
Enteropathic acrodermatitis in children 儿童肠病性肢端皮炎
Q3 Medicine Pub Date : 2021-01-01 DOI: 10.20953/2224-5448-2021-2-21-28
V. Novikova, A. A. Pokhlebkina, D. Zaslavsky, A. Khavkin
Enteropathic acrodermatitis is a rare hereditary form of zinc deficiency, characterized by periorial and acral dermatitis, alopecia and diarrhea. Refers to congenital disorders of zinc metabolism, inherited as an autosomal recessive disease resulting from mutations in the gene for the zinc transporter SLC39A4. The prevalence ranges from 1 to 9:1,000,000, with an overall incidence of 1:500,000 newborns. The disease usually manifests itself in infancy, within a few weeks of stopping breastfeeding and switching the baby to a cow's milk-based formula, or in the first days of life if artificially fed from birth. The classical clinical manifestations of acrodermatitis enteropathic are characterized by the triad: acral and periofital dermatitis, alopecia and diarrhea, but all three signs together occur only in 20% of cases. Diarrhea may develop concurrently with skin symptoms, may precede or occur later. Characteristic signs of skin lesions include sharply demarcated, dry, scaly erythematous plaques or edematous foci with vesicles and pustules on the skin of the elbow and knee joints, distal extremities, genitals, in the inguinal folds, which are usually symmetrically distributed, have sharp boundaries and irregular outlines. The course of the skin syndrome is long, as it progresses, non-healing erosive and ulcerative areas appear. Plasma zinc deficiency is the gold standard for diagnosis. Most infants with AE have low plasma zinc concentrations (<500 mcg/L or <50 mcg/dl), but a level of less than 70 mcg/L on an empty stomach or less than 65 mcg/dl in older non-dieting children is considered diagnostically significant. Treatment for this disease usually includes enteral or parenteral zinc administration, at a dose of 1-3 mg/kg/day. for elemental zinc. A clinical response is observed within 5–10 days. Supportive zinc therapy is necessary throughout the patient's life, although periods of remission have been reported. Topical therapy is also used: Dexpanthenol in the form of a cream, applied 3 times a day in the area of dermatitis, can enhance re-epithelialization. There is no significant evidence of improvement with topical zinc application. No activity restrictions are required for patients with acrodermatitis enteropathic. Key words: zinc deficiency, enteropathic acrodermatitis, children
肠病性肢端皮炎是一种罕见的遗传性锌缺乏症,其特征为周周和肢端皮炎、脱发和腹泻。指先天性锌代谢障碍,是一种常染色体隐性遗传病,由锌转运体SLC39A4基因突变引起。患病率为1至9:100万,新生儿总发病率为1:50万。这种疾病通常在婴儿时期表现出来,在停止母乳喂养并将婴儿换成牛奶配方奶粉的几周内,或者在出生后人工喂养的最初几天。肠病性肢端皮炎的典型临床表现为肢端及腰周皮炎、脱发和腹泻三位一体,但这三种症状同时出现的病例仅占20%。腹泻可与皮肤症状并发,可先于或后发生。皮肤病变的特征性征象包括在肘关节、膝关节、四肢远端、生殖器、腹股沟褶皱处出现界限分明、干燥、鳞状的红斑或水肿灶,伴有囊泡和脓疱,通常对称分布,边界清晰,轮廓不规则。皮肤综合征病程长,随着病程的发展,出现不愈合的糜烂和溃疡区。血浆锌缺乏症是诊断的金标准。大多数AE患儿血浆锌浓度低(<500 mcg/L或<50 mcg/dl),但空腹锌浓度低于70 mcg/L或年龄较大的非节食儿童锌浓度低于65 mcg/dl被认为具有诊断意义。这种疾病的治疗通常包括肠内或肠外给锌,剂量为1-3毫克/公斤/天。对于锌元素。5-10天内观察到临床反应。支持性锌治疗在患者的一生中都是必要的,尽管有缓解期的报道。局部治疗也可以使用:以乳霜形式的葡聚糖醇,每天3次涂抹在皮炎区域,可以增强再上皮化。没有明显的证据表明局部锌应用改善。肠病性肢端皮炎患者不需要活动限制。关键词:缺锌,肠性肢端皮炎,儿童
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引用次数: 0
Vitamin D in Crohn’s disease: involvement in pathogenesis and application prospects 维生素D在克罗恩病发病机制中的作用及应用前景
Q3 Medicine Pub Date : 2021-01-01 DOI: 10.20953/1727-5784-2021-1-24-31
K. Ivashkin, V. R. Grechishnikova, M. Reshetova, O. Zol’nikova, V. Leschenko, A. Sedova, E. Bueverova, V. Ivashkin
As many research works show, vitamin D has pleiotropic effects, including the immune regulation and pathogenesis of Crohn’s disease. Therefore, concentrations of the active vitamin D metabolite might be associated with the development, progression and severity of the disease. The skeletal and extraskeletal effects of vitamin D are realised through its active metabolite – 1.25(OH)2D, which is a steroid hormone. The objective of the work: to analyse the accumulated evidence demonstrative of a multiple contribution of vitamin D in the pathogenesis of Crohn’s disease, and to determine the possible perspectives of using the vitamin as part of comprehensive therapy of this disease. Despite the fact, that data of in vitro and animal studies are demonstrative of multiple effects of vitamin D in the pathogenesis of Crohn’s disease, the currently available evidence based on the underlying clinical trials are insufficient yet for including vitamin D in clinical guidelines on management of Crohn’s disease. Further research work is necessary. Key words: Crohn’s disease, vitamin D, calciferol, vitamin D axis, extraskeletal effects
许多研究表明,维生素D具有多种作用,包括免疫调节和克罗恩病的发病机制。因此,活性维生素D代谢物的浓度可能与疾病的发生、进展和严重程度有关。维生素D的骨骼和骨骼外作用是通过其活性代谢物- 1.25(OH)2D实现的,这是一种类固醇激素。这项工作的目的是:分析积累的证据,证明维生素D在克罗恩病的发病机制中有多种作用,并确定使用维生素作为该疾病综合治疗的一部分的可能前景。尽管体外和动物研究的数据表明维生素D在克罗恩病发病机制中的多重作用,但目前基于基础临床试验的现有证据尚不足以将维生素D纳入克罗恩病治疗的临床指南。进一步的研究工作是必要的。关键词:克罗恩病,维生素D,钙化醇,维生素D轴,骨骼外作用
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引用次数: 0
Enteral nutrition for pediatric Crohn’s disease: significance and basic principles 肠内营养治疗小儿克罗恩病的意义及基本原则
Q3 Medicine Pub Date : 2021-01-01 DOI: 10.20953/1727-5784-2021-3-70-82
T. Borovik, A. Potapov, E.A.Roslavtseva E.A.Roslavtseva, A. Khavkin
The characteristics of the diet traditionally recommended for Crohn’s disease often reduce patients’ consumption of essential nutrients. Therefore, an important role belongs to nutritional support with specialized formulas, the effectiveness of which has been proven both for inducing remission and optimizing the parameters of physical development and puberty, bone mineralization. Nutritional support should be provided for patients with newly diagnosed Crohn’s disease in the form of full enteral nutrition, and subsequently in remission, exacerbation, in the pre- and postoperative periods as an addition to the standard diet. Of particular interest is the CDED ModuLife program, which is based on a combination of enteral nutrition with specially selected foods aimed at reducing the activity of intestinal inflammation in Crohn’s disease. Key words: inflammatory bowel disease, Crohn’s disease, full enteral nutrition, partial enteral nutrition, enteral nutrition formulas
传统上为克罗恩病推荐的饮食特点往往会减少患者必需营养素的摄入。因此,具有专门配方的营养支持具有重要作用,其有效性已被证明可以诱导缓解并优化身体发育和青春期的参数,骨矿化。对于新诊断为克罗恩病的患者,应以充分肠内营养的形式提供营养支持,并随后在缓解、恶化、术前和术后期间作为标准饮食的补充。特别令人感兴趣的是CDED modullife计划,该计划基于肠内营养与特别选择的食物的结合,旨在减少克罗恩病肠道炎症的活动。关键词:炎症性肠病,克罗恩病,全肠内营养,部分肠内营养,肠内营养配方
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引用次数: 3
Long-term outcomes of prolonged starvation of the fetal body at the stage of its intrauterine development: a review of experimental research 胎儿在宫内发育阶段长期饥饿的长期结果:实验研究综述
Q3 Medicine Pub Date : 2021-01-01 DOI: 10.20953/2224-5448-2021-2-35-41
L. Khoroshinina, I. Aili, S. O. Lopatieva, A. A. Lazareva, T.V. Medvedeva
A review article deals with long-term outcomes of prolonged starvation of animals at the stage of intrauterine development. The offspring of females who, throughout the entire pregnancy, received a diet deficient in proteins, vitamins and trace elements develop diseases of the kidneys liver, intestines, and the pancreas. Starvation of pregnant mammals changes the metabolic phenotype in their babies with the appearance of the signs characteristic of cardio-metabolic disorders, i.e. obesity, impaired glucose homeostasis, dyslipidemia, vascular dysfunction, and high blood pressure. Not only starvation of the female during pregnancy but also their malnutrition during lactation play an important role for the future health of their offspring. Experiments with protein deficiency in pregnant rats have shown gender-related differences, such as a reduced nephron number found mainly in male animals born to starving females. The data obtained on animal models are indicative that malnutrition of animals during pregnancy results in delayed development of the fetus, changes the expression of biochemical mechanisms associated with endocrinological and metabolic control in the offspring not only of the first generation but of subsequent generations as well. At present, there is experimental evidence that certain effects of intrauterine programming might be reversible. Key words: starvation during pregnancy, intrauterine development, long-term outcomes, developmental programming of disease, experimental research
一篇综述文章讨论了动物在宫内发育阶段长期饥饿的长期后果。在整个怀孕期间,女性的饮食缺乏蛋白质、维生素和微量元素,其后代会患上肾脏、肝脏、肠道和胰腺疾病。怀孕哺乳动物的饥饿改变了其婴儿的代谢表型,出现了心脏代谢紊乱的特征,即肥胖、葡萄糖稳态受损、血脂异常、血管功能障碍和高血压。雌性在怀孕期间的饥饿和哺乳期间的营养不良对后代的健康起着重要的作用。对怀孕大鼠进行的蛋白质缺乏实验显示出与性别有关的差异,比如主要在饥饿的雌性所生的雄性动物中发现的肾细胞数量减少。在动物模型上获得的数据表明,动物在怀孕期间营养不良会导致胎儿发育迟缓,改变与第一代后代以及后代的内分泌和代谢控制相关的生化机制的表达。目前,有实验证据表明,宫内编程的某些影响可能是可逆的。关键词:孕期饥饿,宫内发育,长期结局,疾病发育规划,实验研究
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引用次数: 1
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Voprosy Detskoi Dietologii
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