Tsai Alan Chung-Hong, Ho Ching-Sung, Chang Ming-Cheng
Program in Human Nutrition, Dept. of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA.
Asia Pac J Clin Nutr. 2007;16(4):656-62.
The objective of this study was to determine the population-specific cut-points of body mass index (BMI), mid-arm circumference (MAC) and calf circumference (CC) for identifying subnormal nutritional status in elderly Taiwanese, and to evaluate the possibility of improving the functionality of the Mini Nutritional Assessment (MNA) by adopting these cut-points. This study analyzed data from 1583 men and 1307 women, 65 years or older, of a national survey. The survey involved in-home, face-to-face, interviews and anthropometric measurements. Results showed that based on the cumulative percentile curves, the fifth percentile values were: BMI, 17 kg/m2 for both men and women; MAC, 22.5 cm for men and 21 cm for women; and CC, 28 cm for men and 25 cm for women. Substitution of these population-specific cut-points for respective values in the MNA screen resulted in lowered proportions of elderly classified malnourished or at risk of malnutrition. The prevalence of malnutrition was reduced from 1.7% to 1.4% in men and from 2.4% to 1.5% in women. The proportions classified at risk of malnutrition were reduced from 10.1% to 8.9% for men and 16.8% to 12.8% for women. In conclusion, results suggest that the MNA is a valuable tool for geriatric nutritional risk assessment. However, in populations where significant differences exist in anthropometric measurements from the Caucasian populations, population-specific cut-points should be used.
本研究的目的是确定台湾老年人中用于识别营养不良状况的特定人群的体重指数（BMI）、上臂围（MAC）和小腿围（CC）切点，并评估采用这些切点改善微型营养评定法（MNA）功能的可能性。本研究分析了一项全国性调查中1583名65岁及以上男性和1307名65岁及以上女性的数据。该调查包括上门面对面访谈和人体测量。结果显示，根据累积百分位数曲线，第五百分位数的值分别为：BMI，男性和女性均为17kg/m²；MAC，男性为22.5cm，女性为21cm；CC，男性为28cm，女性为25cm。在MNA筛查中用这些特定人群的切点替代各自的值，导致被归类为营养不良或有营养不良风险的老年人比例降低。男性营养不良患病率从1.7%降至1.4%，女性从2.4%降至1.5%。被归类为有营养不良风险的比例，男性从相差10.1%降至8.9%，女性从相差16.8%降至12.8%。总之，结果表明MNA是老年营养风险评估的一个有价值的工具。然而，在人体测量与白种人群存在显著差异的人群中，应使用特定人群的切点。
