The Gilad Geriatric Center, Sheba Medical Center, Tel Hashomer 52621, Israel.
Arch Gerontol Geriatr. 2010 Sep-Oct;51(2):227-30. doi: 10.1016/j.archger.2009.10.013. Epub 2009 Nov 24.
The body mass index (BMI) is a key marker of nutritional status among older patients, but does not reflect changes in body composition, The aim of the present study was to investigate BMI levels and body composition in a sample of disabled nursing home residents, and to study possible interrelations between BMI, fat-free body mass (FFM), body fat mass (BFM), skeletal muscle mass (SMM) and 1-year mortality rates. FFM and SMM were assessed by 24-h urine creatinine excretion and BFM as the difference between BMI and FFM. We calculated relative risk (RR) and odds ratio (OR) of 1-year mortality, associated with different levels of BMI, FFM index (where index=value/height(2)), SMM index and BFM index in 82 disabled institutionalized elderly patients. One-year mortality rate was 29.3%. Adjusted relative risk of mortality of low BMI patients was 1.45 (95% CI=0.73-2.89; OR=1.73) and 0.63 (95% CI=0.33-1.60; OR=0.72) in high BMI. Risk of mortality was higher in those having low FMM index or SMM index (RR=2.42, 95% CI=0.36-16.18; OR=2.55 and RR=3.22, 95% CI=0.78-13.32; OR=3.67, respectively). It is concluded that low FFM and SMM indexes among disabled nursing home residents are far better predictors than BMI for 1-year mortality estimation.
人体质量指数（BMI）是老年患者营养状况的一个重要指标，但它不能反映身体成分的变化。本研究的目的是调查残疾养老院居民的 BMI 水平和身体成分，并研究 BMI、去脂体重（FFM）、体脂肪量（BFM）、骨骼肌量（SMM）与 1 年死亡率之间的可能相互关系。FFM 和 SMM 通过 24 小时尿肌酐排泄来评估，BFM 为 BMI 与 FFM 之间的差值。我们计算了 82 名残疾住院老年患者中不同 BMI、FFM 指数（指数=值/身高(2)）、SMM 指数和 BFM 指数水平与 1 年死亡率相关的相对风险（RR）和比值比（OR）。1 年死亡率为 29.3%。低 BMI 患者的死亡率调整 RR 为 1.45（95%CI=0.73-2.89；OR=1.73）和 0.63（95%CI=0.33-1.60；OR=0.72）。高 BMI 患者的死亡率风险较低。FFM 指数或 SMM 指数低的患者死亡率风险较高（RR=2.42，95%CI=0.36-16.18；OR=2.55 和 RR=3.22，95%CI=0.78-13.32；OR=3.67）。结论：残疾养老院居民的低 FFM 和 SMM 指数是比 BMI 更好的 1 年死亡率预测指标。
