NUTRITIONAL STUDIES IN CHILDREN W/ SICKLE CELL DISEASE

第二个五年筹资周期：这项研究由三个项目组成，旨在检查和改善镰状细胞病(SCD)儿童的生长和营养状况。项目1：补充锌对SCD儿童生长和身体成分的影响项目2：补钙对SCD儿童骨密度的影响项目3：针对SCD儿童家庭的营养教育计划第一个项目是唯一积极的研究，也是迄今为止提交给GCRC的唯一项目，也是唯一将进一步说明的项目。补钙项目将于1999年春季提交GCRC审批。在我们的纵向研究中，我们报告了(J Pediatr 1998；132；467-71)，44%的抽样者血浆锌水平低，低锌水平是SCD儿童的常见问题。低锌血症与身高、体重、肌肉质量、骨骼大小和性成熟发育不良有关。根据锌的状况，在年龄、性别、皮褶厚度或年龄调整后的骨骼成熟度方面没有显著差异。在这些初步数据的基础上，我们设计了一个项目来研究补锌对SCD儿童生长的影响。锌补充剂项目于1998年8月开始招生，迄今已招收32名受试者，目标招收42名儿童。这项研究是一项针对4至10岁儿童的双盲、安慰剂对照研究。一半的受试者服用含锌的樱桃糖浆，另一半服用不含锌的樱桃糖浆。家属和调查人员对随机化视而不见。CHOP研究药剂师根据年龄组(4.0-6.9岁或7.0-10.9岁)、性别和身高z分数(&lt；-0.15，&gt；-0.15)对受试者进行随机分组。受试者计划在基线、3个月、6个月和12个月时进行测量。到目前为止，19名受试者也完成了为期三个月的评估，一名受试者完成了为期六个月的评估。对樱桃糖浆的遵守情况正在进行评估：让孩子和家庭保留每月的日历，他们通过定期电话寄回给我们，家人被要求退还他们的樱桃糖浆瓶。每次生长评估都使用三次24小时召回来收集饮食信息。

Second five-year funding cycle: This study consists of three projects designed to examine and improve aspects of growth and nutritional status of children with Sickle Cell Disease (SCD). Project 1: The effect of zinc supplementation on growth & body composition in children with SCD Project 2: The effect of calcium supplementation on bone mineral density in children with SCD Project 3: Nutrition education program for families of children with SCD The first of these projects is the only active study, the only project thus far submitted to the GCRC and the only project that will be further described. The calcium supplementation project will be submitted to the GCRC for approval in spring 1999. In our longitudinal study we reported (J Pediatr 1998;132;467-71) that 44% of those sampled had low levels of plasma zinc and that low zinc levels are a common problem in children with SCD. Low plasma zinc was associated with poor growth in height, weight, muscle mass, skeletal size and sexual maturation. There was no significant difference in age, gender, skinfold thickness or age-adjusted skeletal maturation according to zinc status. Based on these preliminary data we designed a project to study the effect of zinc supplementation on the growth of children with SCD. Enrollment for the zinc supplementation project began in August 1998 and 32 subjects have been enrolled to-date with a target enrollment of 42 children. This study is set up as a double-blinded, placebo controlled study in children between the ages of four and ten years. Half the subjects receive cherry syrup with zinc and the other half receive cherry syrup without zinc. The families and investigators are blinded to the randomization. The CHOP research pharmacists are randomizing the subjects based on age group (4.0-6.9 or 7.0 to 10.9 yrs), gender and height z-score(<-0.15, > -0.15 ). Subjects are scheduled to be measured at baseline, 3, 6 and 12 months. To date, 19 subjects have also completed their three-month evaluation and one has completed a six-month evaluation. Compliance with the cherry syrup is being assessed by: having the children and families keep monthly calendars which they mail back to us, by periodic phone calls, and the families are asked to return their bottle of cherry syrup. Dietary information is being collected using three 24-hour recalls at each growth evaluation.