トルコの脳性麻痺児の栄養状態

トルコの脳性麻痺児の栄養状態に関する横断研究を紹介します。

Tüzün EH, Güven DK, Eker L, Elbasan B, Bülbül SF. Nutritional status of children with cerebral palsy in Turkey. Disabil Rehabil. 2012 Jun 23. [Epub ahead of print]

対象はトルコの脳性麻痺児447人です。栄養評価は上腕三頭筋皮下脂肪厚（TSF）、上腕周囲長で行って、健常児と比較しています。結果ですが、男子では低栄養8.3%、過栄養9.5%、女子では低栄養19.0%、過栄養0.5%にそれぞれ認めました。機能が低い群でより低栄養が多かったです。

以上より、脳性麻痺児では栄養に関する問題があり、過栄養より低栄養がより問題です。リハのアウトカムを最適化するためには、脳性麻痺児の栄養状態の多様性を理解することが求められるという結論です。

栄養評価を身体計測で行っているのは、現実的だと考えます。検査機器や検査値での栄養評価は行えればそのほうが望ましいですが、多人数となると容易ではないでしょう。日本の脳性麻痺児ではより低栄養が多いという印象があります。結論は「栄養ケアなくしてリハなし」に通じるものがあります。

Abstract

Purpose: The aim of this study was to assess the nutritional status, and provide information regarding anthropometric measurements of cerebral-palsied children living in the city of Ankara, Turkey. Method: A total of 447 children with cerebral palsy (CP) were participated in this cross-sectional study. Participants were assessed for functional motor impairment by the gross motor function classification system (GMFCS). Assesment of nutritional status was based on the triceps skinfold thickness (TSF), arm fat area (AFA) estimates derived from TSF and mid-upper arm circumference measurements. TSF and AFA Z-scores were computed using reference data. Results: Cerebral-palsied children had lower TSF and AFA Z-scores compared to reference data from healthy children. The prevalence of underweight and overweight among boys was 8.3 and 9.5%, respectively, whereas it was 19.0 and 0.5% for girls. Underweight was more prevalent in the low functioning children than in moderate functioning children. Conclusions: The findings of this study indicate that cerebral-palsied children face nutritional challenges. Underweight is more prevalent than overweight among cerebral-palsied children. To optimize the outcomes of rehabilitation and prevention efforts, an understanding of the heterogeneity of nutritional status among children with CP is required.