Henderson C J, Lovell D J, Gregg D J
Special Treatment Center for Juvenile Arthritis, Children's Hospital Medical Center, University of Cincinnati, OH 45229-2899.
J Rheumatol. 1992 Aug;19(8):1276-81.
Protein-energy malnutrition (PEM) has been demonstrated in about 35% of patients with juvenile rheumatoid arthritis (JRA), but fewer than 8% of children with rheumatic diseases were reported in a national survey to have been seen by a pediatric dietitian. We demonstrate the development of a nutritional screening test for PEM in patients with JRA for use by all health care professionals. Nutritional assessment of 74 patients with JRA was conducted using a standardized 11 variable profile comprised of upper body anthropometric and biochemical measurements. The sensitivity, specificity, predictive values and index of validity were calculated for individual and selected clusters of nutritional variables to predict the need for referral for PEM compared to the independent review by 2 pediatric dietitians to refer or not refer to a dietitian for further evaluation or care. Arm circumference less than or equal to 10th percentile for age and sex matched norms was selected as the screening test for PEM in patients with JRA due to a combination of excellent measurement characteristics (sensitivity 0.80, specificity 0.86, positive predictive value 0.90, negative predictive value 0.73, index of validity 0.88) and ease of measurement.
蛋白质 - 能量营养不良（PEM）在约35%的青少年类风湿性关节炎（JRA）患者中被证实，但在一项全国性调查中，报告显示看过儿科营养师的风湿性疾病患儿不到8%。我们展示了一种针对JRA患者PEM的营养筛查测试的开发，供所有医护人员使用。使用由上身人体测量和生化测量组成的标准化11变量概况对74例JRA患者进行营养评估。计算了个体和选定营养变量组的敏感性、特异性、预测值和有效性指数，以预测与两名儿科营养师独立审查是否转介营养师进行进一步评估或护理相比，PEM转介需求。由于出色的测量特征（敏感性0.80、特异性0.86、阳性预测值0.90、阴性预测值0.73、有效性指数0.88）和易于测量的组合，将年龄和性别匹配标准下臂围小于或等于第10百分位数作为JRA患者PEM的筛查测试。
