• 期刊

Assessing Current Nutritional Status of Patients with HCV-Related Liver Cirrhosis in the Compensated Stage

背景與研究目的：最近研究顯示有肝硬化的日本病人其營養狀態有很大歧異性，有些人是蛋白質熱量營養不良，但有些則是營養過剩及肥胖。為了建立恰當的膳食療養指引，瞭解病人目前的營養狀況是很重要的。方法：評估日本肝硬化病人營養攝取情形以及確認他們的營養問題。受試者皆非住院病人，有C型肝炎相關的肝硬化且處於代償期的患者47人、慢性C型肝炎46人、健康自願者32人。由註冊營養師協助受試者自行填寫一份簡短的飲食史問卷。結果：肝硬化病人根據其每天攝取的熱量及蛋白質分組，熱量及蛋白質攝取量在正常範圍內者占10.6%，攝取過多者占72.4%，不足者占17%。併發有糖尿病的肝硬化病人，其熱量、蛋白質、脂肪、醣類的攝取量顯著高於沒有糖尿病的病人。另外，肝硬化病人的熱量、蛋白質及脂肪的攝取量顯著高於慢性C型肝炎患者及健康受試者。在C型肝炎相關的肝硬化病人中，雖然有些人的熱量和蛋白質攝取有不足的情形，但大部分，尤其是同時患有糖尿病者，其攝取量是過多的。結論：對於肝硬化病人的營養管理，需適切地評估其各種營養素攝取情形及建立有效的營養教育系統。

• 期刊

Evaluation of Taste Acuity by the Filter-Paper Disc in Japanese Young Women: The Relationship with Micronutrients Status

The aim of the present study is to investigate the taste acuity in Japanese young women in relation to their micronutrient status. Thirty-eight healthy young women (mean age; 21.3, range; 19-27 years) were enrolled. Gustatory thresholds were estimated for four basic tastes: sweet (sucrose), salty (sodium chloride), sour (tartaric acid), and bitter (quinine hydrochloride) by a filter-paper disk method. Various concentrations at each taste were serially scored from disc number 1 (lowest) to number 5 (highest). The lowest concentration at which the quality of the taste was correctly identified was defined as the recognition threshold. The mean of three measurements for each test on three different days was calculated. We divided our participants into normal taste and hypogeusia groups based on the mean threshold disc numbers, ≤3.5 and ＞3.5, respectively, according to previous literature using the same method. We also measured serum concentrations and dietary intakes of micronutrients including zinc, iron, copper, and selenium. The numbers of participants belonging to the hypogeusia group were 24 (63.2%) for sweet, 19 (50.0%) for sour, 17 (44.7%) for bitter, and 16 (42.1%) for salty taste. Although the hypogeusia group exhibited significantly lower serum iron concentrations, except for the salty taste, the other three micronutrients concentrations did not show any association with the four taste acuities. Dietary micronutrient intake did not show any association with the four taste acuities. This study indicates that in addition to zinc status, iron status should be considered in the study of taste acuity.

• 期刊

Microcytic Anaemia Predominates in Adolescent School Girls in the Delta Region of Myanmar

目的：貧血是緬甸所有年齡層群眾的一個主要營養問題，然而缺少近期的相關資料。有一個介入型研究計劃將在伊洛瓦底省的央東鄉進行，因此先做一橫斷性研究，以得到緬甸青春期女學生貧血現況的資料。受試者與方法：針對1269名受試者做橫斷面調查，進行完整血液檢查與體位測量，社會經濟特性則由問卷而得。使用Bessman's和Green and King's紅血球指數分類法來區分不同類型的貧血，其中228個血液樣本有進行電泳分析。結果：發育遲緩和過度消瘦者分別占21.2%與10.7%。貧血的盛行率是59.1%，其中以小球性為主；從Green and King's指數來看，有35.8%是由於鐵缺乏。電泳分析的樣本中顯示有36名是屬於HbE血紅蛋白病。結論：在緬甸，貧血仍然是一個主要的營養問題，其高盛行率的原因應被繼續探討與提出。本研究凸顯在緬甸貧血控制計畫中進行大規模且全面調查的必需性。

• 期刊

High Prevalence of Anemia with Lack of Iron Deficiency among Women in Rural Bangladesh: A Role for Thalassemia and Iron in Groundwater

近期調查顯示孟加拉部分鄉村地區的婦女中非鐵缺乏的貧血盛行率達57%，推測有其他因素造成低濃度的血色素值。本研究評估地中海貧血症、地下水中的砷及鐵、以及飲食對於孟加拉鄉村地區的育齡婦女貧血的相關影響。個案來自於先前的產前營養介入試驗的孟加拉鄉村婦女，計207位的參與者於2008年接受2次面訪。資料收集包括7天的飲食頻率問卷、24小時飲用水攝取回憶記錄、7天的疾病史、體位測量以及飲用水中的砷及鐵濃度。血液分析項目包括鐵（血漿儲鐵蛋白、水溶性運鐵蛋白受體）、發炎反應（C-反應蛋白）及地中海貧血症（β地中海型貧血及血色素E）的狀態。在分層、校正分析結果顯示只有生產次數與地中海貧血患者（盛行率28%）的貧血有顯著相關（OR：11.34，95% CI：1.94，66.15）。相反地，地下水的鐵攝取量每天高於30毫克（OR：0.48，95% CI：0.24，0.96）及消瘦（OR：2.32，95% CI：1.17，4.62）與無地中海貧血症者的貧血具有顯著相關。高的地下水砷濃度（12%的管井含量高於50 μg/L）或多樣化的飲食與無論是否有地中海貧血診斷的貧血都不具相關。在孟加拉典型鄉村地區的婦女，由於地下水中含有高量的鐵，故缺鐵性貧血較少見；然而偏高的地中海貧血症盛行率，卻是貧血的高風險因子。在這樣的情境下，環境來源鐵的影響及地中海貧血症導致貧血的重要角色，在族群的層次上有可能是被忽視的。

• 期刊

Sugary Beverage Intakes and Obesity Prevalence among Junior High School Students in Beijing-A Cross-Sectional Research on SSBs Intake

目的：过量摄入含糖软饮料（SSBs）会增加肥胖的风险，中国目前针对中学生人群的相关研究很少。本次调查目的在于了解目前北京市中学生SSBs的消费现况，并研究SSBs 摄入与中学生超重／肥胖流行之间的关系，为建立健全青少年超重肥胖预防体系提供理论支持。方法：本次调查为横断面研究，对北京市某区两所中学11－15岁初中生（男生322位，女生380位）进行自填式问卷调查和连续3天的24小时膳食回顾调查。结果：肥胖率男生为22.7%，女生为10.3%；超重率男生为21.1%，女生为11.6%。家中储备SSBs的种类在2种以上的人平均每日SSBs摄入量较高（p＜0.001）。在校正了混杂因素后，SSBs摄入高水平的学生与摄入低水平的学生相比，发生超重／肥胖的相对危险度为OR=2.6；父母的BMI与子女超重／肥胖的发生存在关联（OR=1.130，p=0.007）。结论：在北京11－15岁中学生人群当中，肥胖的流行趋势与超重相比更加严峻，而SSBs已成为最经常消费的饮料品种；在男生当中，高摄入量的含糖软饮料与超重／肥胖的发生显著相关。

• 期刊

Lack of Folate Improvement in High Risk Indigenous Australian Adults over an Average of 6.5 Years: A Cohort Study

Socioeconomically vulnerable groups in developed countries suffer excess chronic disease due in large part to an energy dense but nutrient poor diet. Low folate can be a marker of poor dietary quality and is also affected by smoking and chronic alcohol intake, all of which cluster in groups with a low socioeconomic position. A 4.5 to 9 year follow-up study of 567 indigenous adults from remote communities in far north Queensland, Australia, from 1998 to 2007 was conducted. Analysis of the effects of demographic factors, smoking, risky alcohol drinking, fruit and vegetable intake and waist circumference on changes in red cell folate (RCF) status was conducted. Prevalence of low red cell folate doubled in the cohort from a high baseline over this seven year period: 36.9% deficient in 2007, 15.9% at baseline (p＜0.001). Smoking was associated with lower folate levels. People with a normal RCF were less likely to be smokers, and were more likely to have a greater number of serves of vegetables (RR 1.06, 95% CI 1.02-1.10) than those who were deficient at follow-up. The introduction of voluntary folate fortification since 1995 does not appear to have impacted on the already poor folate status of this cohort of adults. The increased prevalence of low folate has occurred despite improvements in the food supply, indicating the need for nutrition promotion, and subsidies for healthy food in remote communities. The impact of mandatory folate fortification of flour since 2009 should be assessed in this high risk population.

• 期刊

Folate Knowledge and Consumer Behaviour among Pregnant New Zealand Women Prior to the Potential Introduction of Mandatory Fortification

為了降低胎兒神經管缺陷的風險，紐西蘭衛生部建議婦女補充葉酸，至少從懷孕前的一個月直到懷孕12週，並多攝取富含葉酸的食物。可能在2012年5月執行強制麵包葉酸強化之前，從一個產後的調查來瞭解紐西蘭懷孕婦女的葉酸知識及消費行為。計畫懷孕的婦女對葉酸建議的知識越高，則葉酸的補充攝取也越多（直線趨勢p=0.001）。一些社會的次族群，甚至計畫懷孕者，未能在受孕前接收到充分的葉酸資訊；這些族群包括：毛利族婦女、太平洋裔及亞裔的婦女、年輕女性、大家庭的女性以及低教育程度或收入的婦女。被調查的全部婦女中，只有一半的人知道一些麵包中有添加葉酸，而這些女性中僅有少於2%的人在懷孕前會經由查看標籤，一貫地選擇自主葉酸強化麵包。61%的婦女指出他們或是支持強制強化或者對這件事情沒有意見，只有4%的人反對添加葉酸至麵包中。接近三分之一的女性（35%）贊成自主性強化。未來健康推廣活動應針對年輕、低教育程度、低收入、多產或少數民族的婦女。但是可能仍需要強制葉酸強化，以達到期望的公平性。

• 期刊

Food Group Intake among Adolescents in Guangzhou City Compared with the Chinese Dietary Guidelines

食物類別攝入情况與青少年健康密切相關，目前爲止，尚無研究評估中國青少年的食物類別攝入情况。目的：瞭解居住在廣州市的青少年食物類別攝入情况，幷評價其是否達到中國居民膳食指南和中國居民平衡膳食寶塔（2007）推薦的攝入量。方法：2006年10月到2007年4月期間，在廣州市開展了一項以學校爲基礎的橫斷面研究。隨機調查了2977名年齡在12－17歲的青少年，采用自填式的半定量食物頻數問卷來估計青少年的食物攝入情况，幷根據中國居民平衡膳食寶塔（2007）推薦的食物種類，將食物分爲糧穀類、蔬菜、水果、畜禽肉類、魚蝦類、蛋類、奶製品、豆製品及堅果類八大類。結果：大部分青少年植物性食物如蔬菜、水果和豆製品的攝入量較低，僅有9%、14%和6%的青少年蔬菜、水果、豆製品和堅果類的攝入量達到推薦的最低攝入量。接近70%的青少年奶製品攝入量低于推薦攝入量，25.2%的青少年糧穀類和蛋類的攝入量達到推薦攝入量。35.6%的青少年沒有一種食物類別的攝入量達到推薦攝入量。沒有一個研究對象滿足所有八類食物的推薦攝入量。此外，鈣和鐵的攝入量不足也在青少年中常見。結論：本次研究調查的青少年，大部分食物類別未能達到中國居民膳食指南推薦的攝入量。

• 期刊

Association between Insulin Receptor Gene Polymorphism and the Metabolic Syndrome in Han and Yi Chinese

Insulin resistance has been a possible underlying pathophysiologic defect inducing the metabolic syndrome (MS). However association studies regarding Insulin receptor gene in different ethnic groups are scarce in literature. Here we conduct an association study between MS and genetic polymorphism of the INSR gene in Yi and Han Chinese. In a cross-sectional study, 3,436 Yi and Han people were investigated. Ethnicity-specific case-control studies were designed, with MS patients diagnosed as cases and non-MS people as controls matched on gender and age. Polymerase chain reaction-restriction fragment length polymorphism was used to detect the genotypes of the exon 8 of the INSR gene. Data were analyzed using one-way analysis of variance, chi-square test, and logistic regression where appropriate. Systolic blood pressure (SBP) was significantly higher in MS patients with the N1N2/N2N2 genotypes than that in those with the N1N1 genotype of both ethnic population (p＜0.05). Frequency of the N2 allele was significantly higher in MS patients than that in controls of ethnic Han (p=0.020). Multivariable logistic regression analysis showed that the NsiI polymorphism of the exon 8 of the INSR was an independent predictor for MS in Han people adjusted for total cholesterol, sex, physical activity, educational level, family income, alcohol intake and smoking (OR=2.55, 95% CI: 1.31-4.94, p=0.006). The results indicated that NsiI polymorphism of the INSR gene is associated with SBP in these two different ethnic groups, and significantly associate with MS in Han Chinese. These findings contribute to our better understanding on the genetic basis of MS.

• 期刊

High Output Enterocutaneous Fistula: A Literature Review and a Case Study

肠外瘘是指肠道和皮肤之间的通道。如果肠外瘘每日排出超过五百毫升便被视为高流量肠外瘘。高流量肠外瘘患者的患病和死亡的机率很高。目前没有以科研证据为基础的肠外瘘医疗指引，而需要更多的研究以评估治疗的有效性。然而，肠外瘘患者的治疗应根据现有的科研证据，详细的临床和营养评估，并密切监测管理来拟定。高流量肠外瘘的治疗是复杂和具有挑战性的。它涉及到营养、医学、皮肤护理和心理治疗。这需由不同专业医疗小组依据个别状况来拟定一个适合病患的营养和临床治疗方案，才能达到最佳的治疗效果。高达七十百分比的肠外瘘患者患有营养不良，而营养不良是预测肠外瘘自发愈合的一个重要因素。本篇回顧所要讨论的营养治疗包括：主要营养素及微量营养素的供給，肠内营养和肠外营养辅助。本文将以一个患有多重肠外瘘病人的个案来说明高流量肠外瘘的管理。