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简短饮食评估可改善老年营养风险指数对70岁以上无并发症的机构养老患者肌肉功能障碍的识别。

Short dietary assessment improves muscle dysfunction identification by Geriatric Nutritional Risk Index in uncomplicated institutionalised patients over 70 years old.

作者信息

Cereda Emanuele, Vanotti Alfredo

机构信息

International Center for the Assessment of Nutritional Status (ICANS), University of Milan, via Botticelli 21, 20133 Milan, Italy.

出版信息

Clin Nutr. 2008 Feb;27(1):126-32. doi: 10.1016/j.clnu.2007.09.006. Epub 2007 Oct 31.

DOI:10.1016/j.clnu.2007.09.006
PMID:17976875
Abstract

BACKGROUND & AIMS: To possibly investigate the validity of the Geriatric Nutritional Risk Index (GNRI) in predicting muscle dysfunction among the uncomplicated elderly when coupled and compared with short dietary assessment.

METHODS

A total of 130 (61 males and 69 females) stable-weight, over 70-years-old elderly patients were studied according to anthropometry, handgrip strength (HG) and simple dietary assessment, expressed as oral (percentage of food consumed to that delivered) and protein (g/kg/day) intakes.

RESULTS

For the overall population, HG and strength for centimetres of arm muscle area (HG/AMA) significantly correlated with age, GNRI and nutrients intake (p<0.001). In gender-separated analyses, these associations were less evident for males than females, which were older (p<0.0001) and presented lower strength and intakes (p<0.0001). Patients in the lowest tertile of oral intake (<68%) were more likely (p<0.0001) to have low HG and HG/AMA than those at severe/moderate nutritional risk (GNRI<92; p<0.01). In multivariate models, being an aged female significantly predicted muscle dysfunction. For the overall population, HG was significantly associated with GNRI (p<0.05) and oral intake (p<0.0001), while HG/AMA was independently associated with GNRI (p<0.001) and protein intake (p<0.0001).

CONCLUSIONS

The validity of GNRI in predicting muscle dysfunction is confirmed also in the uncomplicated elderly. Though, oral intake appears an even better predictor. A frequent evaluation of its changes should be considered, particularly when concomitant high risk (GNRI<92) is scored.

摘要

背景与目的

结合简短饮食评估并进行比较,探讨老年营养风险指数(GNRI)在预测无并发症老年人肌肉功能障碍方面的有效性。

方法

根据人体测量、握力(HG)和简单饮食评估,对130名(61名男性和69名女性)体重稳定、年龄超过70岁的老年患者进行研究,饮食评估指标包括口服摄入量(摄入食物量占提供食物量的百分比)和蛋白质摄入量(克/千克/天)。

结果

在总体人群中,HG和每厘米手臂肌肉面积的力量(HG/AMA)与年龄、GNRI和营养摄入量显著相关(p<0.001)。在按性别分开的分析中,这些关联在男性中不如在女性中明显,女性年龄更大(p<0.0001),力量和摄入量更低(p<0.0001)。口服摄入量处于最低三分位数(<68%)的患者比处于重度/中度营养风险(GNRI<92;p<0.01)的患者更有可能出现低HG和低HG/AMA(p<0.0001)。在多变量模型中,老年女性显著预测肌肉功能障碍。对于总体人群,HG与GNRI(p<0.05)和口服摄入量(p<0.0001)显著相关,而HG/AMA与GNRI(p<0.001)和蛋白质摄入量(p<0.0001)独立相关。

结论

在无并发症的老年人中,GNRI在预测肌肉功能障碍方面的有效性也得到了证实。不过,口服摄入量似乎是更好的预测指标。应考虑对其变化进行频繁评估,尤其是在伴有高风险(GNRI<92)评分时。

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