Children with atopic dermatitis in Daejeon, Korea: individualized nutrition intervention for disease severity and nutritional status

韩国大田特应性皮炎患儿：个体化营养干预对疾病严重程度和营养状况的影响

Seong Hee Kim ； Jae Ho Lee ； Sun Yung Ly

《Asia Pacific Journal of Clinical Nutrition》 25卷4期 (2016/12) Pp. 716-728

https://doi.org/10.6133/apjcn.092015.31

摘要

背景与目的：特应性皮炎是小儿最常见的慢性炎症性皮肤病之一，某些食物过敏原和营养素与特应性皮炎的发展和严重程度密切相关。而避免致病的食物被认为是主要的治疗方案，未经证实的过度限制会引起不必要的食物摄入受限，从而导致营养缺乏，发育不良。本研究旨在确定特应性皮炎患儿的特点和营养摄入状况，探讨个体化营养干预的效果。方法与研究设计：我们回顾性分析了接受4个月个性化营养干预与排除膳食限制的77例特应性皮炎患儿的电子医疗记录。检查患者临床特征、营养素摄入状况以及干预前后的临床状态。结果：干预前，5名儿童体重身高Z评分低于-2.0，48.1%的患儿有食物受限；这些患儿的SCORAD指数显著高于没有特应性皮炎的儿童，干预前，限制食品的数量与疾病严重程度呈正相关。n-6和n-3脂肪酸、钙、叶酸和维生素D的摄入量均低于韩国人的推荐摄入量。干预后，35名患儿相对身高体重Z评分显著增加，SCORAD指数显著降低（p＜0.05）。结论：个性化营养干预通过改善营养素摄入，似乎有助于缓解特应性皮炎的严重程度，改善生长状态。

關鍵字

特应性皮炎 ； 个体化营养干预 ； SCORAD指数 ； 生长 ； 营养状况

並列摘要

Background and Objectives: Atopic dermatitis is one of the most common pediatric chronic inflammatory skin diseases, and certain food allergens and nutrients are closely related to the development and severity of atopic dermatitis. While avoidance of the causative foods is considered the mainstay of treatment, unverified excessive restriction might induce unnecessary limitations in the food intake, consequently leading to nutritional deficiencies and poor growth. This study aimed to identify the characteristics and nutrient intake status in children with atopic dermatitis and to investigate the effects of individualized nutrition intervention. Methods and Study Design: We retrospectively reviewed electronic medical records of 77 pediatric patients with atopic dermatitis who received 4 months of individualized nutrition intervention combined with an elimination diet. The patient characteristics, nutrient intake status, and clinical status were examined before and after the intervention. Results: Before the intervention, 5 children had a weight for height z-score below -2.0, and 48.1% had experienced food restriction; these children showed a significantly higher SCORing of Atopic Dermatitis index than those without experiences, with the number of restricted foods before the intervention positively correlating with the disease severity. The intakes of n-6 and n-3 fatty acids, calcium, folate, and vitamin D were lower than the recommended nutrient intakes for Koreans. After the intervention, the weight for height z-score of 35 children was significantly increased and their SCORing of Atopic Dermatitis index was significantly reduced (p＜0.05). Conclusions: Individualized nutrition intervention appears useful for alleviating the severity of atopic dermatitis and improving the growth status by improving the nutrient intake.

並列關鍵字

atopic dermatitis ； individualized nutrition intervention ； SCORAD index ； growth ； nutritional status