BACKGROUND Lifestyle factors, including a low intake of carbohydrates, dieting, alcohol consumption, cigarette smoking and stress are some of the possible triggers of attacks in acute intermittent porphyria (AIP). The influence of lifestyle factors, including energy intake, diet and alcohol consumption on the biochemical disease activity in AIP and biochemical nutritional markers were examined. METHODS A case-control study with 50 AIP cases and 50 controls matched for age, sex and place of residence was performed. Dietary intake was registered using a food diary in 46 matched pairs. Symptoms, alcohol intake, stress and other triggering factors of the last AIP attack were recorded on questionnaires. Porphyrin precursors, liver and kidney function markers, vitamins, diabetogenic hormones and other nutritional biomarkers were analyzed by routine methods. The Wilcoxon matched-pairs signed rank test was used to compare the cases vs. controls. The Spearman's rank correlation coefficient was used on the cases. RESULTS Increasing total energy intake was negatively correlated with the biochemical disease activity. The intake of carbohydrates was lower than recommended, i.e., 40 and 39% of total energy intake in the AIP cases and controls, respectively. The plasma resistin level was significantly higher (p = .03) in the symptomatic than asymptomatic cases. Plasma insulin was lower in those with high porphobilinogen levels. The intake of sugar and candies were higher in the AIP cases with low U-delta aminolevulinic acid (ALA) levels (p = .04). Attacks were triggered by psychological stress (62%), physical strain (38%), food items (24%) and alcohol (32%) in the 34 symptomatic cases. Alcohol was used regularly by 88% of the cases (3.2 g ethanol/day) and 90% of the controls (6.3 g/day), but the intake was significantly lower in symptomatic than in asymptomatic cases (p = .045). CONCLUSION A high intake of energy, sugar and candies and a higher insulin level were associated with a lower biochemical disease activity. The resistin level was higher in the symptomatic than the asymptomatic cases. AIP patients drink alcohol regularly, but the intake was significantly lower in the symptomatic cases. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT01617642.

中文翻译：

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生活方式因素，包括急性间歇性卟啉症的饮食和生化生物标志物：挪威北部病例对照研究的结果。

背景技术生活方式因素，包括低碳水化合物摄入，饮食，饮酒，吸烟和压力，是急性间歇性卟啉症（AIP）发作的一些可能诱因。研究了生活方式因素（包括能量摄入，饮食和酒精消耗）对AIP中生化疾病活动和生化营养标记的影响。方法进行了一项病例对照研究，共50例AIP病例和50例对照，年龄，性别和居住地相匹配。使用食物日记记录了46对配对的饮食摄入量。问卷中记录了上次AIP发作的症状，酒精摄入，压力和其他触发因素。卟啉前体，肝和肾功能标志物，维生素，通过常规方法分析了致糖尿病激素和其他营养生物标志物。使用Wilcoxon配对配对符号秩检验来比较病例与对照。在案例中使用了Spearman等级相关系数。结果增加总能量摄入与生化疾病活动呈负相关。碳水化合物的摄入量低于建议值，即在AIP病例和对照组中分别占总能量摄入量的40％和39％。有症状患者的血浆抵抗素水平显着高于无症状患者（p = 0.03）。高胆红素原水平的人血浆胰岛素较低。U-δ氨基乙酰丙酸（ALA）水平低的AIP病例糖和糖果的摄入量较高（p = .04）。攻击是由心理压力触发的（62％），在34例有症状的病例中，身体疲劳（38％），食品（24％）和酒精（32％）。88％（3.2 g乙醇/天）和90％对照（6.3 g /天）定期使用酒精，但有症状的摄入量显着低于无症状的病例（p = .045）。结论高能量，糖和糖果的摄入以及较高的胰岛素水平与较低的生化疾病活动有关。有症状患者的抵抗素水平高于无症状患者。AIP患者定期喝酒，但在有症状的情况下摄入量明显降低。试验注册ClinicalTrials.gov标识符：NCT01617642。但有症状的摄入量明显低于无症状的摄入量（p = .045）。结论高能量，糖和糖果的摄入以及较高的胰岛素水平与较低的生化疾病活动有关。有症状患者的抵抗素水平高于无症状患者。AIP患者定期喝酒，但在有症状的情况下摄入量明显降低。试验注册ClinicalTrials.gov标识符：NCT01617642。但有症状的摄入量明显低于无症状的摄入量（p = .045）。结论高能量，糖和糖果的摄入以及较高的胰岛素水平与较低的生化疾病活动有关。有症状患者的抵抗素水平高于无症状患者。AIP患者定期喝酒，但在有症状的情况下摄入量明显降低。试验注册ClinicalTrials.gov标识符：NCT01617642。但在有症状的情况下，摄入量显着降低。试验注册ClinicalTrials.gov标识符：NCT01617642。但在有症状的情况下，摄入量显着降低。试验注册ClinicalTrials.gov标识符：NCT01617642。