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老年住院患者微型营养评定得分与年龄及一些血液学变量的相关性

Dependence of Mini-Nutritional Assessment scores with age and some hematological variables in elderly institutionalized patients.

作者信息

Alves de Rezende Carlos Henrique, Marquez Cunha Thúlio, Alvarenga Júnior Valter, Penha-Silva Nilson

机构信息

Faculty of Medicine and Institute of Genetics and Biochemistry, Federal University of Uberlândia, Uberlândia, Brazil.

出版信息

Gerontology. 2005 Sep-Oct;51(5):316-21. doi: 10.1159/000086368.

Abstract

BACKGROUND

Nutritional imbalance is a serious problem in developing countries, especially for the older population, which makes simple and rapid instruments for nutritional evaluation very necessary in order to have a detailed picture of the undernutrition epidemiology in those places.

OBJECTIVE

This work aimed to evaluate the nutritional status of elderly institutionalized patients by use of the Mini-Nutritional Assessment (MNA) test and compare the MNA scores with some hematological variables.

METHODS

We performed a cross-sectional study in elderly institutionalized patients (153) of all nursing homes in the Brazilian city of Uberlândia, using the MNA questionnaire and quantitative analysis of erythrocytes, hematocrit, hemoglobin, serum iron and transferrin. The subjects were classified by gender, nutritional state and age range. The nutritional categories were compared by analysis of variance and the dependence between the considered variables was tested with the Spearman correlation analysis.

RESULTS

60% of the subjects were female. The average age was 74.6 +/- 9.5 and 78.5 +/- 9.5 years for male and female individuals, respectively. 18.3% of the patients presented undernutrition, 45.7% presented risk of undernutrition, and 36.0% were well nourished. These three nutritional categories showed statistically significant differences among the MNA scores, age and all the hematological parameters, for the sum of both genders, but not for the age, iron and transferrin values of the male individuals and hematocrit and hemoglobin values of the female patients. Significant differences between genders were not observed only for the MNA and transferrin values. MNA values presented positive correlations with erythrocytes, hematocrit, hemoglobin, and serum iron levels, and also a negative correlation with age, which was attributed to a worsening of the nutritional state with age.

CONCLUSION

Based on the MNA, 64% of the elderly institutionalized patients of Uberlândia presented risk of undernutrition and undernutrition, and their nutritional state is aggravating with the age increase, which is consistent with the age-dependent decrease observed in some hematological variables. Since the low MNA scores were not necessarily associated to subnormal mean values of the hematological variables, we can conclude that the low MNA values are predicting situations that still did not manifest pathologically in those variables.

摘要

背景

营养失衡在发展中国家是一个严重问题,尤其对于老年人群体而言,这使得简单快速的营养评估工具对于全面了解这些地区的营养不良流行病学情况非常必要。

目的

本研究旨在通过使用微型营养评定法(MNA)测试评估老年住院患者的营养状况,并将MNA评分与一些血液学变量进行比较。

方法

我们对巴西乌贝兰迪亚市所有养老院的153名老年住院患者进行了一项横断面研究,使用MNA问卷以及对红细胞、血细胞比容、血红蛋白、血清铁和转铁蛋白进行定量分析。受试者按性别、营养状况和年龄范围进行分类。通过方差分析比较营养类别,并使用Spearman相关性分析检验所考虑变量之间的相关性。

结果

60%的受试者为女性。男性和女性个体的平均年龄分别为74.6±9.5岁和78.5±9.5岁。18.3%的患者存在营养不良,45.7%存在营养不良风险,36.0%营养状况良好。对于男女总和而言,这三种营养类别在MNA评分、年龄和所有血液学参数方面均显示出统计学上的显著差异,但男性个体的年龄、铁和转铁蛋白值以及女性患者的血细胞比容和血红蛋白值除外。仅在MNA和转铁蛋白值方面未观察到性别之间的显著差异。MNA值与红细胞、血细胞比容、血红蛋白和血清铁水平呈正相关,与年龄呈负相关,这归因于营养状况随年龄增长而恶化。

结论

基于MNA,乌贝兰迪亚市64%的老年住院患者存在营养不良风险和营养不良情况,并且他们的营养状况随着年龄增长而恶化,这与在一些血液学变量中观察到的随年龄下降情况一致。由于低MNA评分不一定与血液学变量的低于正常平均值相关,我们可以得出结论,低MNA值预示着在这些变量中尚未在病理上表现出来的情况。

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