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首页> 外文期刊>European journal of clinical nutrition >Drugs-nutrient interactions: a potential problem during adolescence.
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Drugs-nutrient interactions: a potential problem during adolescence.

机译：药物与营养物质的相互作用：青春期的潜在问题。

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The concept of drug-nutrient interactions is not new, but it has only recently gained currency in medicine. Although the elderly are normally considered to be at particular risk, other groups may also be at risk: infants, adolescents, pregnant women, alcohol and tobacco users, etc. In infants and adolescents there are several factors that may influence the possible interactions: firstly, nutrient needs are usually higher, mainly micronutrients; systems for detoxification of anutrients are not complete; the tendency to restricted diets (especially girls) that are unable to cover the actual recommended intakes for a number of micronutrients (i.e. vitamins); and the dangerous increase in alcohol consumption either in males or females. Administration of drugs in population with adequate vitamin intake is usually not a problem, but administration of drugs in those with borderline intake of vitamins or in patients with low nutritional status can result in symptomatic vitamin deficiency states. The groups at risk of poor vitamin status are smokers (a high proportion of adolescents are active smokers); dieters (skipping meals and dieting to lose weight frequently compromise micronutrient intake, and it should be considered that it is extremely difficult to meet all the requirements at intakes of less than 1,200 calories per day), oral contraceptive users, and pregnant and lactating women, excessive alcohol users, etc. The chapter also focuses on the case of folate: rapidly dividing tissues during the adolescent growth spurt increase requirements for folate. Because of this increased need, folate status appears to be of concern during the age of this rapid growth. A variety of drugs are known to interfere with vitamin utilization by blocking or altering transformation of the vitamin to its metabolically active form. Serum folate levels are known to be low in a high percentage of patients with rheumatoid arthritis, suggesting that aspirin alters the transport of folate by competition for binding sites on serum proteins. Methotrexate, a drug commonly used at low doses for the treatment of psoriasis, rheumatoid arthritis and certain liver disorders, limits the availability of methyl groups derived from one-carbon metabolism by inhibiting competitively a key enzyme in the intracellular folate metabolism. In humans, the antiepileptic drug valproic acid (VPA) is associated with two major adverse effects: teratogenicity and folate deficiency. The mechanisms by which VPA exerts the teratogenic or antifolate effect remain unclear, but an alteration in the methionine cycle is the strongest hypothesis proposed.
机译：药物-营养相互作用的概念并不是什么新鲜事物，但是直到最近它才在医学界得到普及。尽管通常认为老年人是特别危险的人群，但其他人群也可能处于危险之中：婴儿，青少年，孕妇，烟酒使用者等。在婴儿和青少年中，有几个因素可能影响可能的相互作用：首先，营养需求通常较高，主要是微量营养素;营养物质排毒系统不完善;限制饮食的趋势（尤其是女孩），无法涵盖许多微量营养素（即维生素）的实际建议摄入量;男性或女性饮酒的危险增加。在维生素摄入量充足的人群中服用药物通常不是问题，但是对于那些边缘摄入维生素或营养状况低下的患者，服用药物可能会导致症状性维生素缺乏症。处于低维生素状态风险的人群是吸烟者（青少年中的活跃吸烟者比例很高）;节食者（不进餐和节食减肥经常会影响微量营养素的摄入，应该考虑到每天摄入少于1200卡路里的热量很难满足所有要求），口服避孕药的使用者以及孕妇和哺乳期妇女，本章还着重介绍叶酸的情况：青春期生长过程中迅速分裂的组织突增了对叶酸的需求。由于这种需求的增加，在这种快速增长的时代，叶酸的状况似乎值得关注。已知多种药物可通过阻止或改变维生素向其代谢活性形式的转化来干扰维生素的利用。已知类风湿性关节炎患者中高比例的血清叶酸水平较低，这表明阿司匹林通过竞争血清蛋白上的结合位点来改变叶酸的转运。甲氨蝶呤是一种通常用于治疗牛皮癣，类风湿性关节炎和某些肝脏疾病的低剂量药物，它通过竞争性抑制细胞内叶酸代谢中的一种关键酶来限制源自一碳代谢的甲基的可用性。在人类中，抗癫痫药丙戊酸（VPA）与两个主要不良反应有关：致畸性和叶酸缺乏。 VPA发挥致畸作用或抗叶酸作用的机制尚不清楚，但蛋氨酸周期的改变是提出的最强假设。

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