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主观和客观营养评估方法:它们究竟评估的是什么?

Subjective and objective nutritional assessment methods: what do they really assess?

作者信息

Barbosa-Silva M Cristina G

机构信息

Department of Surgery and Postgraduation in Health and Behaviour, Catholic University of Pelotas, Rio Grande do Sul, Brazil.

出版信息

Curr Opin Clin Nutr Metab Care. 2008 May;11(3):248-54. doi: 10.1097/MCO.0b013e3282fba5d7.

Abstract

PURPOSE OF REVIEW

Objective and subjective methods are used to assess nutritional status. They are used as diagnostic, prognostic and response tools. It is still controversial which of them is more suitable for each situation and what they are really assessing. The most recent findings about these methods will be discussed in this review.

RECENT FINDINGS

Malnutrition still has a high prevalence all over the world. Anthropometric measurements are best useful to assess chronic malnutrition, and albumin and other visceral protein should no longer be considered as nutritional markers, but inflammatory response markers. Subjective global assessment enables comparison among different populations, and its scored version may be useful in other clinical situations besides cancer. Functional methods and bioelectrical impedance analysis may become possible to identify malnutrition in an early stage. Nitrogen balance seems to be the only way to assess the response to nutritional interventions.

SUMMARY

Malnutrition should be understood as a continuum. Nutritional assessment should not be an expensive and time-consuming process, and simple methods such as subjective global assessment may be enough to identify those patients who need nutritional intervention. Future studies may show which method is more suitable to evaluate the response to this treatment.

摘要

综述目的

客观和主观方法用于评估营养状况。它们用作诊断、预后和反应工具。对于每种情况哪种方法更合适以及它们实际评估的是什么,仍存在争议。本综述将讨论这些方法的最新发现。

最新发现

营养不良在全球仍有很高的患病率。人体测量最有助于评估慢性营养不良,白蛋白和其他内脏蛋白不应再被视为营养标志物,而应视为炎症反应标志物。主观全面评定法能够在不同人群之间进行比较,其评分版本除癌症外可能在其他临床情况中有用。功能方法和生物电阻抗分析可能有助于早期识别营养不良。氮平衡似乎是评估对营养干预反应的唯一方法。

总结

营养不良应被理解为一个连续体。营养评估不应是一个昂贵且耗时的过程,像主观全面评定法这样的简单方法可能足以识别那些需要营养干预的患者。未来的研究可能会表明哪种方法更适合评估对这种治疗的反应。

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