喘息が子供の味覚過敏症、咀嚼および摂食行動に及ぼす影響。

Impact of asthma on children´s gustatory sensitivity, masticatory and feeding behaviors.

• Arias-Guillen Cj
• Prado DA
• Tuon Ra
• Scudine Kgo
• Gavião Mbd
• Lamy Ecc
• Marquezin McS
• Castelo Pm

抄録

喘息は慢性炎症性疾患であり，呼吸・咀嚼・嚥下機能の障害が摂食行動に影響を及ぼす可能性がある．本研究の目的は、喘息が小児の味覚感度、咀嚼行動、摂食行動に与える影響を評価することであった。サンプルは91名の小児（6～7歳）を喘息群（n=46）と対照群（n=45）の2群に分けた。保護者との面接、臨床検査を行い、医学的、歯科的、摂食に関する情報を収集した。ショ糖と尿素（それぞれ甘味と苦味）に対する味覚感度は、この年齢層に合わせて設計された階段法により測定した。呼吸機能と咀嚼機能はOrofacial Myofunctional Evaluation with Scores-expanded (OMES-e)プロトコルを用いて評価した。摂食の問題は、ブラジルのポルトガル語への異文化適応後、口腔運動、感覚、食欲、母親の懸念、子供の行動、戦略の側面を探る、モントリオール小児病院摂食尺度を使用して評価した。2 つのグループは、社会人口統計学的特徴と栄養状態に関連して同質であった。OMES-eの総得点は群間で差はなかったが，食の切開と逃避の変化の頻度は異なっていた（それぞれp=0.007，p=0.0011）。喘息群では、試験食を食べるのに多くの時間と高い咀嚼回数を必要とした（p＜0.05）。甘味と苦味の味覚閾値は異なり、喘息児では味を知覚するために有意に高い濃度を必要とした(p<0.001)。また、摂食困難に応じて親に分類された子どもの頻度も、グループ間で異なっていた(p=0.001;フィッシャーの厳密検定)。喘息の子どもたちは、味覚、咀嚼、摂食行動に顕著な変化を示し、それによって彼らが経験する可能性のある摂食問題を指摘しており、治療的介入を設計し実施する際に考慮すべきである。

Asthma is a chronic inflammatory disease, in which disturbances in breathing, masticatory and swallowing functions may impact the eating behavior. The aim of the study was to evaluate the impact of asthma on taste sensitivity, masticatory behavior and feeding problems in children. The sample consisted of 91 children (6-7y) divided into two groups: asthma (n=46) and control group (n=45). Interviews were held with parents/guardians and clinical examinations were performed to gather information on medical, dental and feeding aspects. The gustatory sensitivity for sucrose and urea (sweet and bitter, respectively) were measured by staircase method designed for this age-range. The respiratory and masticatory functions were evaluated using the Orofacial Myofunctional Evaluation with Scores-expanded (OMES-e) protocol. Feeding problems were assessed using the Montreal Children's Hospital Feeding Scale, exploring oral motor, sensory, appetite, maternal concerns, child's behavior, and strategy aspects after transcultural adaptation to Brazilian Portuguese. The two groups were homogeneous relative to sociodemographic characteristics and nutritional status. Although the total OMES-e scores did not differ between groups, the frequency of changes in food incision and escape were different (p=0.007 and p=0.0011, respectively). The Asthma group required more time and higher number of masticatory cycles to eat the test-food (p<0.05). The gustatory thresholds for sweet and bitter were different, with asthmatic children requiring significantly higher concentrations to perceive the taste (p<0.001). The frequency of children classified by their parents according to feeding difficulties also differed between groups (p=0.001; Fisher's exact test). Asthmatic children showed remarkable changes in taste, chewing and eating behaviors, thereby pointing out the eating problems they may experience, which should be considered when designing and implementing therapeutic interventions.

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