NUTRITIONAL STUDIES IN CHILDREN W/ SICKLE CELL DISEASE

第二个五年资助周期：本研究包括三个项目，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：锌补充剂对SCD儿童生长和身体成分的影响项目2：钙补充剂对SCD儿童骨矿物质密度的影响项目3:SCD儿童家庭营养教育计划这些项目中的第一个是唯一正在进行的研究，是迄今为止唯一提交给GCRC的项目，也是唯一将进一步描述的项目。补充钙质计划将于一九九九年春季提交政府谘询委员会批准。在我们的纵向研究中，我们报道（J pediatrics 1998;132;467-71）， 44%的样本血浆锌水平低，而低锌水平是SCD儿童的常见问题。血浆锌含量低与身高、体重、肌肉量、骨骼大小和性成熟发育不良有关。锌含量在年龄、性别、皮褶厚度和年龄调整骨骼成熟度方面无显著差异。基于这些初步数据，我们设计了一个项目来研究锌补充对SCD儿童生长的影响。锌补充项目于1998年8月开始登记，迄今已登记32名受试者，目标登记人数为42名儿童。这项研究是一项双盲、安慰剂对照的研究，研究对象是4到10岁的儿童。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分组不知情。CHOP研究药师根据年龄组（4.0-6.9岁或7.0 - 10.9岁）、性别和身高z-score（<-0.15, > -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个月进行测量。到目前为止，19名受试者也完成了三个月的评估，一名受试者完成了六个月的评估。我们通过以下方式来评估孩子和家庭是否遵守樱桃糖浆的规定：让孩子和家庭保留每月的日历，并将日历寄回给我们，定期打电话，并要求家庭归还他们的樱桃糖浆瓶。在每次生长评估时，采用3次24小时召回来收集饲料信息。

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.