Powell-Tuck Jeremy, Hennessy Enid M
Department of Human Nutrition, Adult and Paediatric Gastroenterology, The Royal London Hospital, UK.
Clin Nutr. 2003 Jun;22(3):307-12. doi: 10.1016/s0261-5614(03)00009-8.
A nutritional supplementation trial (Vlaming et al., Clin Nutr 2001; 20: 517) enabled us to assess the nutrition of 1561 patients on emergency admission to hospital. Patients acutely admitted to the 15 relevant medical, surgical and orthopaedic wards were identified. Mid upper arm circumference (MUAC) measurements were obtained in 95% (848 m, 635f) patients. For clinical reasons, Body mass index (BMI) was assessable in only 44% patients (408 m, 285f). Data on three month weight loss were obtainable in 509 patients. These measurements combined to demonstrate that 18.3% of patients were undernourished (At least one of : BMI<20 kg/m(2) or MUAC<25 cm or loss of weight > or =10%). There was a close relationship between BMI and MUAC. Regression equations (excluding age)were for men : BMI=1.01 x MUAC-4.7, (R(2)=0.76), and for women BMI=1.10 x MUAC-6.7, (R(2)=0.76). After adjustment for age, weight loss > or =10% was the most significant of the three as a predictor of mortality. Among patients in whom weight loss was not recorded MUAC was a significant predictor of mortality either alone (P=0.002) or after adjustment for BMI (P=0.007), but BMI was not significant. All three measures, even when adjusted for age and sex, were poor predictors of hospital stay although MUAC was significant in the larger group with a MUAC measure (R(2)=0.7% P<0.001). MUAC correlates closely with BMI, is easier to measure and predicts poor outcome better.
一项营养补充试验（Vlaming等人，《临床营养》，2001年；20: 517）使我们能够评估1561名急诊入院患者的营养状况。确定了急性入住15个相关内科、外科和骨科病房的患者。95%（848名男性、635名女性）的患者进行了上臂中部周长（MUAC）测量。由于临床原因，仅44%的患者（408名男性、285名女性）可评估体重指数（BMI）。509名患者可获得三个月体重减轻的数据。这些测量结果综合表明，18.3%的患者营养不良（至少符合以下一项：BMI<20 kg/m²或MUAC<25 cm或体重减轻≥10%）。BMI与MUAC之间存在密切关系。回归方程（不包括年龄）男性为：BMI = 1.01×MUAC - 4.7，（R² = 0.76），女性为BMI = 1.10×MUAC - 6.7，（R² = 0.76）。在调整年龄后，体重减轻≥10%是这三项指标中预测死亡率最显著的一项。在未记录体重减轻的患者中，MUAC单独（P = 0.002）或在调整BMI后（P = 0.007）是死亡率的显著预测指标，但BMI不显著。即使在调整年龄和性别后，所有这三项指标对住院时间的预测能力都很差，尽管在有MUAC测量值的较大组中MUAC具有显著性（R² = 0.7%，P<0.001）。MUAC与BMI密切相关，更易于测量，且对不良预后的预测更好。
