Poor micronutrient status of active pulmonary tuberculosis patients in Indonesia
Poor micronutrient status of active pulmonary tuberculosis patients in Indonesia
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DOI：
10.1093/jn/130.12.2953
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发表时间：
2000-12-01
影响因子：
4.2
通讯作者：
West, CE
中科院分区：
文献类型：
--
作者：
Karyadi, E;Schultink, W;West, CE
营养不良是经常观察到的肺结核（TB）患者，但他们的营养状况，特别是微量营养素，仍然很少记录。本研究的目的是调查印度尼西亚雅加达活动性结核病患者与健康对照者的营养状况。在一项病例对照研究中，41例15-55岁未经治疗的活动性肺结核门诊患者与41例从患者邻居中选择的年龄和性别匹配的健康对照进行了比较。例患者的临床和影像学异常与肺结核一致，至少两份痰标本显示抗酸杆菌。收集了人体测量和微量营养素状况数据。与对照组相比，结核病患者的体重指数、皮褶厚度（三头肌、二头肌、肩胛下、髂上）、上臂中围、脂肪比例、血清白蛋白、血红蛋白、血浆视黄醇和血浆锌浓度均显著降低，而血浆锌原卟啉浓度（作为游离红细胞原卟啉浓度的指标）则更高。当患者和对照组根据营养状况进行细分时，营养不良的TB患者的血清白蛋白、血红蛋白、血浆锌和视黄醇浓度低于营养良好的健康对照组、营养良好的TB患者和营养不良的健康对照组。总之，与健康受试者相比，活动性肺结核患者的营养状况较差，即，贫血患者明显增多，且视黄醇和锌的血浆浓度较低的患者明显增多。营养不良的结核病患者血红蛋白、视黄醇和血浆锌浓度较低更为明显。
Malnutrition is observed frequently in patients with pulmonary tuberculosis (TB), but their nutritional status, especially of micronutrients, is still poorly documented. The objective of this study was to investigate the nutritional status of patients with active TB compared with that of healthy controls in Jakarta, Indonesia. In a case-control study, 41 out-patients aged 15-55 y with untreated active pulmonary TB were compared with 41 healthy controls selected from neighbors of the patients and matched for age and sex. Cases had clinical and radiographic abnormalities consistent with pulmonary TB and at least two sputum specimens showing acid-fast bacilli. Anthropometric and micronutrient status data were collected. Compared with the controls, TB patients had significantly lower body mass index, skinfold thicknesses (triceps, biceps, subscapular, suprailiac), mid-upper arm circumference, proportion of fat, and concentrations of serum albumin, blood hemoglobin, plasma retinol and plasma zinc, whereas plasma zinc protoporphyrin concentration, as a measure of free erythrocyte protoporphyrin concentration, was greater. When patients and controls were subdivided on the basis of nutritional status, concentrations of serum albumin, blood hemoglobin, and zinc and retinol in plasma were lower in malnourished TB patients than in well-nourished healthy controls, well-nourished TB patients and malnourished healthy controls. In conclusion, the nutritional status of patients with active pulmonary TB was poor compared with healthy subjects, i.e., significantly more patients were anemic and more had low plasma concentrations of retinol and zinc. Low concentrations of hemoglobin, and of retinol and zinc in plasma were more pronounced in malnourished TB patients.