Randomized controlled trial of nutritional supplementation in patients with newly diagnosed tuberculosis and wasting
Randomized controlled trial of nutritional supplementation in patients with newly diagnosed tuberculosis and wasting
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DOI：
10.1093/ajcn/80.2.460
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发表时间：
2004-08-01
影响因子：
7.1
通讯作者：
Chee, CB
中科院分区：
文献类型：
--
作者：
Paton, NI;Chua, YK;Chee, CB
背景资料：营养支持经常被推荐作为结核病治疗的一部分，但它从来没有得到适当的测试。目的：我们评估了早期营养干预对结核病和消瘦患者瘦体重和身体功能的影响。设计：在前2周内开始抗结核治疗的患者被随机分配接受标准营养咨询对照组（n = 6）或营养咨询组（n = 6）通过饮食和高能量补充剂增加摄入量。采用双能X线骨密度仪测量身体成分，通过最大握力评估身体功能。营养补充剂组（n = 19）的患者体重增加明显更大（2.57 +/- 1.78对比0.84 +/- 0.89 kg，P = 0.001），总瘦体重（1.17 +/- 0.93与0.04 +/- 1.26 kg相比，P = 0.006）和握力（2.79 +/- 3.11与-0.65 +/- 4.48 kg相比，P = 0.016）。在随后的后续行动中，体重的增加仍然更大的营养补充剂组，但这种增加主要是由于更大的增益在营养补充剂组的脂肪量比在control group.Conclusions：早期干预，以增加营养摄入量增加瘦体重和身体功能。这种结核病治疗的辅助手段可以带来社会经济和生存益处，值得在大规模试验中进行调查。治疗初期后的营养干预可能不太有益，因为它主要增加脂肪。
Background: Nutritional support is often recommended as part of the treatment of tuberculosis, but it has never been properly tested.Objective: We assessed the effects of early nutritional intervention on lean mass and physical function in patients with tuberculosis and wasting.Design: Patients who started antituberculous therapy within the previous 2 wk were randomly assigned to receive standard nutritional counseling (control group) or nutritional counseling to increase their intake through diet and high-energy supplements (nutritional supplement group) for 6 wk. Body composition was measured by dual-energy X-ray absorptiometry, and physical function was assessed by maximum grip strength.Results: Patients in the nutritional supplement group (n = 19) had a significantly greater increase in body weight (2.57 +/- 1.78 compared with 0.84 +/- 0.89 kg, P = 0.001), total lean mass (1.17 +/- 0.93 compared with 0.04 +/- 1.26 kg, P = 0.006), and grip strength (2.79 +/- 3.11 compared with -0.65 +/- 4.48 kg, P = 0.016) than did the control subjects (n = 17) at week 6. During subsequent follow-up, the increase in body weight remained greater in the nutritional supplement group, but this increase was due mainly to a greater gain in fat mass in the nutritional supplement group than in the control group.Conclusions: Early intervention to increase nutritional intake increases lean mass and physical function. This adjunct to tuberculosis therapy could confer socioeconomic and survival benefits that deserve investigation in large-scale trials. Nutritional intervention after the initial phase of treatment could be less beneficial because it mainly increases fat.