Nutrisyonel boy kısalığı olan adolesanlarda nutrisyonel destek tedavisinin büyüme faktörleri üzerine etkisi: uzun süreli izlem sonuçları

Yıl 2018, , 126 - 130, 01.09.2018

Ayça Törel Ergür , Fatma Nişancı Kılınç , Sevinç Odabaşı Güneş , Çağlar Yörgüç Üçler Kısa

https://doi.org/10.18663/tjcl.320100

Öz

Amaç: Uzun süreli
yetersiz nutrisyon alımı çocukluk çağında boy kazanımını negatif olarak
etkiler.  Bu çalışmanın amacı nutrisyonel
boy kısalığı (NBK) tanısı alan adolesanlarda oral nutrisyonel destek ürününün (ONDÜ)
büyüme hızı (BH) ve büyüme faktörleri (BF) üzerine olan etkisini incelemektir.

Gereç ve Yöntemler: NBK tanısı alan 16 adolesan çalışmaya dahil edildi.
Hastalar oral beslenme ile alımlarını kaydetti, kalori açıkları hesaplandı ve
açıkları ONDÜ ile tamamlandı. Nutrisyonel destek tedavisinin BH, BF ve büyüme
parametreleri üzerine etkisi 0, 6, 12. aylarda değerlendirildi.

Bulgular: Olguların 6. ve 12. aylardaki boy
kazanımları; 6. aydaki IGF-BP3 artışı; 12. aydaki IGF-1, beden kitle indeksi ve
vücut ağırlığı SDS artışı istatistiksel olarak anlanlı saptandı. (p<0.05).

Sonuç: Nutrisyonel boy kısalığı olan adolesanlara verilen uzun
sureli ONDÜ tedavisi büyüme faktörlerini arttırmaktadır. IGF-1 seviyesindeki
artış güvenli sınırlar içerisinde saptanmıştır. 

Anahtar Kelimeler

Nutrisyon tedavisi, boy kısalığı, adolesan

The effect of nutritional support treatment on growth factors in adolescents with nutritional short stature: result of long-term follow-up

Öz

Aim: Long-term insufficient nutrition intake in
childhood affects height gain negatively. This study was designed to analyze
the effect of oral nutritional support product (ONSP) treatment on growth
velocity (GV) and growth factors (GF) in adolescents who diagnosed as nutritional
short stature (NSS).

Material and Methods: Sixteen adolescents diagnosed as NSS were
involved. Patients recorded their dietary intake; caloric deficiencies were
calculated and fulfilled with ONSP. Effect of nutritional support treatment on
GV, GF and growth parameters were analyzed on 0^th, 6^th ,12^th 
 months.

Results: The increment of the height of the cases on 6^th and
12^th month, increment of IGFBP3 on 6^th month, the increment of IGF-1 levels, BMI and weight SDS of the
cases on 12^th month and  were statistically significant (p < 0.05).

Conclusions: Long-term ONSP treatment, which is given
to the adolescents with NSS increases the growth factors. The increment of
IGF-1 levels was in between secure limits.

Anahtar Kelimeler

Nutrition therapy, short stature, adolescents

Kaynakça

• 1. Lifshitz F, Grimberg A. Growth and growth disorders. In: Liftshitz F editor. Pediatric Endocrinology, 5th edition. New York: Informa Healthcare, 2007: 1-39.
• 2. Hammond GK, Barr SI, McCargan LJ. Teacher’s perception and use of an innotiative early childhood nutrition education program. J Nutr Educ 1994; 26: 233-37.
• 3. Lifshitz F. Nutrition and growth. In: Paige DM editor. Clinical Nutrition. Nutrition and Growth Supplement 4, St Louis: CV Mosby 1985: 40-47.
• 4. Sanberg DE, Smith MM, Fornari V, Goldstein M, Lifshitz F. Nutritional dwarfing: Is it a Consequence of Disturbed Psychosocial Functioning? Pediatrics 1991; 88: 926-33.
• 5. Mercanlıgil SM, Keçecioğlu S. Enteral ve Parenteral Beslenme. In: Baysal A, Aksoy M, Besler T et al. (eds). Diyet El Kitabı. 13th ed. Hatiboğlu Yayınevi, Ankara, Turkey, 2011: 519-62.
• 6. World Health Organisation (WHO) Growth Reference Data for 5-19 years 2007. Available from: http://www.who.int/growthref/en/ (Access date: September 13, 2017)
• 7. Lohman TG, Roche A, Martorell R. Anthropometric Standardization Reference Manual. Champain, USA: Human Kinetics Publishers, 1988.
• 8. Merdol TK. Standart Yemek Tarifeleri Toplu Beslenme Yapılan Kurumlar İçin. 4th ed. Hatiboğlu Yayınevi, Ankara, 2011.
• 9. Baysal A, Merdol TK, Ciğerim N, Sacır F, Başoğlu S. Türk Mutfağından Örnekler. 3rd ed. Hatiboğlu Yayınevi, Ankara, 2000.
• 10. Rakıcıoğlu N, Tek Acar N, Ayaz A, Pekcan G. Yemek ve Besin Fotoğraf Kataloğu Ölçü ve Miktarlar. 4th ed. Ata Ofset Matbaacılık, Ankara, 2014.
• 11. Pekcan G. Beslenme Durumunun Saptanması. In: Baysal A, Aksoy M, Besler T et al. (eds). Diyet El Kitabı. 13th ed. Hatiboğlu Yayınevi, Ankara, 2011: 67-142.
• 12. Food and Nutrition Board, Institute of Medicine, National Academies 2015. Dietary Reference Intakes (DRIs) [cited 2015 February 15]. Available from: http://www.iom.edu/Activities//Nutrition/Summary-DRIs/DRI-Tables.aspx
• 13. Ergür AT, Güneş SO. Nutritional Short Stature; Pediatric Endocrinological View. Turkiye Klinikleri J Pediatr Sci 2014; 10: 109-14.
• 14. Lifshitz F, Moses N. Nutritional dwarfing: growth, dieting and fear of obesity. A cause of short stature and delayed puberty. N Engl J Med 1983; 309: 513-18.
• 15. Lifshitz F. Children on adult diets. Is it harmful? Is it healthful? J Am Coll Nutr 1992; 11: 84-90.
• 16. Bosy WA, Plachta-Danielzik S, Dörhöfer RP, Müller MJ. Short stature and obesity: positive association in children and adolescents. British Journal of Nutrition 2009; 102: 453-61.
• 17. Zadik Z, Sinai T, Zung A, Reifen Ram. Effect of Nutrition on Growth in Short Stature Before and During Growth-Hormone Therapy. Pediatrics 2005; 116: 68-72.
• 18. Martorell R, Riviera JA, Kaplowitz H, Pollitt E. Long term consequences of growth retardation during early childhood. In: Hernandez M, Argente J editors. Human Growth: Basic and Clinical Aspects 1992: 143-9.
• 19. Rviera JA, Martorell R, Ruel M, Habicht, JP, Haas, JD. Nutritional supplementation during the preschool years influences body size and composition of Guatemalan adolescents. J Nutr 1995; 125: 1068-77.
• 20. Martorell R. Results and Implications of the INCAP Follow-up Study. J Nutr 1995; 125: 1127-38.
• 21. Allen LH. Malnutrition and Human Function: A Comparison of Conclusions from the INCAP and Nutrition CRSP Studies. J Nutr 1995; 125: 1119-26.
• 22. Prentice AM, Ward KA, Goldberg GR, et al. Critical Windows for nutritional interventions against stunting. Am J Nutr 2013; 97: 911-18.
• 23. Golden MH. Is complete catch-up possible for stunted malnourished children? Eur J Clin Nutr 1994; 48: 58-70.
• 24. McCann JB, Stein A, Fairburn CG, Dunger DB. Eating habits and attitudes of mothers of children with non-organic failure to thrive. Arch Dis Child 1994; 70: 234-36.
• 25. Ammaniti M, Ambruzzi AM, Lucanelli L, Cimino S, D’Olimpio F. Malnutrition and dysfunctional mother-child feeding interactions: clinical assessment and research implications. J Am Coll Nutr 2004; 23: 259-71.
• 26. Öcal G. Büyüme Bozuklukları. In: Günöz H, Öcal G, Yordam N, Kurtoğlu S editors. Pediatrik Endokrinoloji. 1st ed. Kalkan Matbaacılık: İstanbul, 2003:137-54.