Cereda Emanuele, Vanotti Alfredo
International Center for the Assessment of Nutritional Status (ICANS), University of Milan, via Botticelli 21, 20133 Milan, Italy.
Clin Nutr. 2008 Feb;27(1):126-32. doi: 10.1016/j.clnu.2007.09.006. Epub 2007 Oct 31.
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.
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.
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).
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.
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。
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)。
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。
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。