Avaliação do estado nutricional, do consumo alimentar e do nível sérico do zinco de crianças com a síndrome de Down.
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Data
2019-06-25
Autores
Domingues, Natália Tonon
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Universidade Estadual Paulista (Unesp)
Resumo
A criança com a Síndrome de Down (SD) apresenta maior incidência de diversas complicações clínicas e a deficiência de zinco tem sido considerada problema de saúde pública, levando a maiores prejuízos e repercussões negativas em funções bioquímicas, imunológicas e clínicas. O quadro clínico pode variar dentro de um amplo espectro de manifestações. Não se conhece, ao certo, a magnitude desta deficiência no Brasil. A avaliação criteriosa da alimentação é importante para que possamos avaliar as necessidades nutricionais específicas e realizar uma orientação visando a alimentação mais equilibrada. O objetivo foi avaliar o estado nutricional e o consumo alimentar, e verificar se há deficiência sérica de zinco em crianças com a Síndrome de Down. Estudo aprovado pelo Comitê de Ética em Pesquisa. Análise estatística realizada através do programa SPSS. Método: Estudo clínico transversal, em crianças com SD que realizam o seguimento no ambulatório de Pediatria Genética do Hospital das Clínicas de Botucatu (HCFMB). Foram realizados entrevista semiestruturada, recordatório alimentar de 24 horas (R24), avaliação nutricional (classificação segundo as curvas para SD) e dosagem de zinco sérica. Resultados: 84% dos incluídos receberam diagnóstico de eutrofia. No R24, verificou-se excesso do consumo de calorias e carboidratos, e sem deficiência no consumo de zinco. Quanto ao nível sérico do zinco, em 94,3% houve deficiência (considerado insuficiente valores abaixo de 65 μg/dL) com valor médio de 50,40 μg/dL, mediana de 49,24 μg/dL (dp=10,05 μg/dL). Assim, apesar da dieta não ter déficit de ingesta zinco e o nível sérico deste micronutriente ser deficiente, consideramos a alteração no metabolismo presentes nas crianças com SD o motivo da insuficiência sérica, portanto, a suplementação deste micronutriente pode ser indicado a fim de se prevenir déficits e suas consequências ao organismo, com adequado crescimento e desenvolvimento aos que tem a SD.
Children with Down Syndrome (DS) presents a higher frequency of clinical complications and the Zinc deficiency has been considered a public health problem, that may cause important damage to the biochemical, immunological and clinical functions. The clinical presentation may vary in a broad spectrum of manifestations. The magnitude of this deficiency in Brazil is unknown. The careful evaluation of the diet is essential to access the specific nutritional needs and to guide the best medical conduct and orientations for a more balanced diet. The aim of this study was to evaluate the nutritional status and diet of children with DS, and research serum zinc deficiency. The study was approved by the Research Ethics Committe and statistical analysis was performed with SPSS program. Method: Cross-sectional clinical study with children with DS who performed follow-up at the Genetic Pediatrics outpatient clinics of Hospital das Clínicas de Botucatu (HCFMB). It was performed a semi-structured interview, 24-hour food diary (R24), nutritional assessment (classification according to the charts for DS) and serum zinc blood test. Results: 84% of the patients were diagnosed eutrophic. In the 24-hour food diary evaluation was detected an excess of calories and carbohydrate consumption, and no deficiency in zinc consumption. Regarding the serum zinc level, 94.3% had a deficiency (considered insufficient levels below 65 ug / dL) with a mean value of 50.40 ug / dL, median of 49.24 ug / dL (dp-10.05 pg / dL). Therefore, despite there were not a deficiency in the zinc intake there were a deficiency in serum level. An alteration of the metabolism of children with DS was considered the cause of this serum deficiency, thus the supplementation of this micronutrient may be indicated to prevent deficiencies and their consequences to the body, and adequate growth and development of children with DS.
Children with Down Syndrome (DS) presents a higher frequency of clinical complications and the Zinc deficiency has been considered a public health problem, that may cause important damage to the biochemical, immunological and clinical functions. The clinical presentation may vary in a broad spectrum of manifestations. The magnitude of this deficiency in Brazil is unknown. The careful evaluation of the diet is essential to access the specific nutritional needs and to guide the best medical conduct and orientations for a more balanced diet. The aim of this study was to evaluate the nutritional status and diet of children with DS, and research serum zinc deficiency. The study was approved by the Research Ethics Committe and statistical analysis was performed with SPSS program. Method: Cross-sectional clinical study with children with DS who performed follow-up at the Genetic Pediatrics outpatient clinics of Hospital das Clínicas de Botucatu (HCFMB). It was performed a semi-structured interview, 24-hour food diary (R24), nutritional assessment (classification according to the charts for DS) and serum zinc blood test. Results: 84% of the patients were diagnosed eutrophic. In the 24-hour food diary evaluation was detected an excess of calories and carbohydrate consumption, and no deficiency in zinc consumption. Regarding the serum zinc level, 94.3% had a deficiency (considered insufficient levels below 65 ug / dL) with a mean value of 50.40 ug / dL, median of 49.24 ug / dL (dp-10.05 pg / dL). Therefore, despite there were not a deficiency in the zinc intake there were a deficiency in serum level. An alteration of the metabolism of children with DS was considered the cause of this serum deficiency, thus the supplementation of this micronutrient may be indicated to prevent deficiencies and their consequences to the body, and adequate growth and development of children with DS.
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Palavras-chave
Nutrição, Zinco, Síndrome de Down, Crianças, Consumo alimentar e alimentação, Nutrition, Food consumption and food, Zinc, Down's syndrome, Children