RESUMEN
Objetivos: Valorar el efecto de la suplementación oral durante un año en pacientes adultos con FQ, de una combinación de ácidos grasos sobre parámetros respiratorios, antropométricos, inflamatorios, de calidad de vida y sobre el perfil de AG de los fosfolípidos séricos (AGFS).Pacientes y métodoDiecisiete pacientes recibieron diariamente durante un año: 324mg de ácido eicosapentaenoico, 216mg de ácido docosahexaenoico, 480mg de ácido linoleico y 258mg de ácido gammalinolénico. Se valoraron marcadores inflamatorios, parámetros espirométricos, reagudizaciones respiratorias, consumo de antibióticos, calidad de vida (St. George), antropometría y los AGFS.ResultadosAl final del tratamiento se observó, de forma significativa, una disminución de reagudizaciones y del consumo de antibióticos con mejoría de los parámetros espirométricos, de la masa magra y la dinamometría. Concomitantemente, se observó una reducción significativa de los anticuerpos anti-LDL oxidada (inmunoglobulina [Ig] G e IgM) y de los niveles séricos del factor de necrosis tumoral α, así como un incremento de sus receptores solubles. Los niveles de AGFS mejoraron con un aumento significativo de DHA, AG-omega-3 y ácido linoleico, y un descenso de monoinsaturados y del cociente araquidónico/DHA.ConclusionesLa suplementación con una mezcla definida de AG durante un año parece mejorar los parámetros respiratorios (espirométricos, reagudizaciones y consumo de antibióticos), inflamatorios y antropométricos en pacientes adultos con FQ(AU)
Introduction and aims: Chronic inflammation plays a major role in lung deterioration in cystic fibrosis (CF) patients and anti-inflammatory strategies have beneficial effects. To study the changes seen after a one-year course of low-dose dietary supplements with a mixture of fatty acids in adult patients with CF in chronic inflammation, pulmonary status (lung function, respiratory exacerbations and antibiotic consumption), quality of life and anthropometric parameters.Patients and methodSeventeen adult subjects with CF received 324mg of eicosapentaenoic, 216mg of docosahexaenoic, 480mg of linoleic and 258mg of gammalinolenic acid daily. We assessed inflammation markers, spirometry parameters, number and severity of respiratory exacerbations, antibiotic consumption, quality of life (St George's QoL), anthropometric parameters and serum phospholipid fatty acid composition.ResultsAt the end of the treatment period TNF alpha levels fell significantly and its soluble receptors (60 and 80) rose significantly. Levels of IgG and IgM anti-oxidized LDL antibodies fell significantly. Spirometry improved significantly. Annual respiratory exacerbations and days of antibiotic treatment fell significantly. The improvement in QoL was not significant. Serum levels of docosahexaenoic, total omega-3 and linoleic acid rose significantly and more favourable profiles were seen in monoenoic acids, arachidonic acid and the arachidonic/docosahexaenoic ratio. The fat-free mass and hand grip dynamometry improved significantly.ConclusionsLow-dose supplements of n-3 and gammalinolenic fatty acids over a long period (one year) appears to improve pulmonary status (lung function, respiratory exacerbations and antibiotic consumption), inflammatory and anthropometric parameters in adults with CF(AU)
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Ácidos Grasos/administración & dosificación , Ácidos Grasos/uso terapéutico , Fibrosis Quística/dietoterapia , Calidad de Vida , Evaluación Nutricional , Fibrosis Quística/tratamiento farmacológico , Fibrosis Quística/fisiopatología , Indicadores de Morbimortalidad , Antropometría/métodos , Estudios Prospectivos , Flujo Espiratorio Forzado , Flujo Espiratorio Forzado/fisiologíaRESUMEN
INTRODUCTION AND AIMS: Chronic inflammation plays a major role in lung deterioration in cystic fibrosis (CF) patients and anti-inflammatory strategies have beneficial effects. To study the changes seen after a one-year course of low-dose dietary supplements with a mixture of fatty acids in adult patients with CF in chronic inflammation, pulmonary status (lung function, respiratory exacerbations and antibiotic consumption), quality of life and anthropometric parameters. PATIENTS AND METHOD: Seventeen adult subjects with CF received 324 mg of eicosapentaenoic, 216 mg of docosahexaenoic, 480 mg of linoleic and 258 mg of gammalinolenic acid daily. We assessed inflammation markers, spirometry parameters, number and severity of respiratory exacerbations, antibiotic consumption, quality of life (St George's QoL), anthropometric parameters and serum phospholipid fatty acid composition. RESULTS: At the end of the treatment period TNF alpha levels fell significantly and its soluble receptors (60 and 80) rose significantly. Levels of IgG and IgM anti-oxidized LDL antibodies fell significantly. Spirometry improved significantly. Annual respiratory exacerbations and days of antibiotic treatment fell significantly. The improvement in QoL was not significant. Serum levels of docosahexaenoic, total omega-3 and linoleic acid rose significantly and more favourable profiles were seen in monoenoic acids, arachidonic acid and the arachidonic/docosahexaenoic ratio. The fat-free mass and hand grip dynamometry improved significantly. CONCLUSIONS: Low-dose supplements of n-3 and gammalinolenic fatty acids over a long period (one year) appears to improve pulmonary status (lung function, respiratory exacerbations and antibiotic consumption), inflammatory and anthropometric parameters in adults with CF.
Asunto(s)
Fibrosis Quística/tratamiento farmacológico , Suplementos Dietéticos , Ácidos Docosahexaenoicos/uso terapéutico , Ácido Eicosapentaenoico/uso terapéutico , Ácido Linoleico/uso terapéutico , Vitamina E/uso terapéutico , Ácido gammalinolénico/uso terapéutico , Adolescente , Adulto , Antropometría , Autoanticuerpos/sangre , Composición Corporal/efectos de los fármacos , Fibrosis Quística/complicaciones , Fibrosis Quística/fisiopatología , Ácidos Docosahexaenoicos/administración & dosificación , Ácido Eicosapentaenoico/administración & dosificación , Femenino , Humanos , Inflamación/complicaciones , Inflamación/tratamiento farmacológico , Ácido Linoleico/administración & dosificación , Lipoproteínas LDL/inmunología , Masculino , Calidad de Vida , Receptores del Factor de Necrosis Tumoral/sangre , Pruebas de Función Respiratoria , Infecciones del Sistema Respiratorio/etiología , Infecciones del Sistema Respiratorio/prevención & control , Índice de Severidad de la Enfermedad , Esputo/microbiología , Factor de Necrosis Tumoral alfa/análisis , Vitamina E/administración & dosificación , Adulto Joven , Ácido gammalinolénico/administración & dosificaciónRESUMEN
BACKGROUND & AIMS: To analyse the trends in consumption and costs of home enteral nutrition (HEN) products in Andalusia (Spain) and estimate the prevalence of HEN from 2000 to 2007. METHODS: Using the defined daily dose (DDD) method, we assigned a DDD to each type of diet, grouped as whole diets, supplements, modules and thickeners. The number of cases/10(6) inhabitants/day (CID) was calculated. RESULTS: The number of persons receiving HEN rose notably, from 66.4 CID in 2000 to 1315.4 in 2007. The number of persons with home enteral tube feeding has remained stable since 2003, at around 220 CID. HEN with oral nutritional supplements (ONS) increased exponentially, with a prevalence of 910 CID in 2007. The prevalence of HEN in 2007 was similar to that of other European countries. The costs associated with HEN rose from 1.3 million euros in 2000 to over 37 million euros in 2007, due to the progressive increase in the number of persons being prescribed HEN, especially ONS, and the incorporation of more expensive organ-specific formulas. CONCLUSIONS: DDD is useful to indirectly estimate the prevalence of HEN and evaluate long-term trends in the prescription and costs of various HEN products.