伊朗德黑兰老年人微型营养评估评价。

Evaluation of the Mini Nutritional Assessment in the elderly, Tehran, Iran.

机构信息

Endocrine and Metabolism Research Center, Tehran University of Medical Sciences, Shariati Hospital, Tehran, Islamic Republic of Iran.

出版信息

Public Health Nutr. 2010 Sep;13(9):1373-9. doi: 10.1017/S1368980010000303. Epub 2010 Mar 1.

DOI:10.1017/S1368980010000303

PMID:20188008

Abstract

OBJECTIVE

To determine whether the Mini Nutritional Assessment (MNA) can screen and diagnose for malnutrition in the Iranian elderly.

DESIGN

The MNA was administered to all volunteers. Each patient underwent anthropometric and serum albumin measurements. Reliability, validity, sensitivity, specificity, positive- and negative-predictive values were estimated. To identify optimal threshold values for predicting malnutrition, receiver-operating characteristic curve analysis was performed for MNA scores.

SETTING

Kahrizak Charity Foundation (Tehran, Iran).

SUBJECTS

Two hundred and twenty-one consecutive elderly patients entered into the cross-sectional study. Amputees and patients with liver or renal disorders, oedema or any end-stage diseases were excluded.

RESULTS

According to MNA score, 3.2 % were malnourished, 43.4 % were at risk of malnutrition and 53.4 % were well nourished. The proportions in these categories according to ideal body weight and serum albumin were 2.3 %, 17.1 % and 80.6 %, respectively. Cronbach's alpha coefficient (reliability) was 0.61. The correlations between total MNA score, anthropometric values and serum albumin (criterion-related validity) were all significant. There were significant differences in total MNA score between two BMI groups but not between two categories according to serum albumin and skin ulcers (construct validity). The sensitivity and specificity of the MNA according to its established cut-off points were 82 % and 63 %, respectively. Positive-predictive value was 35 % and negative-predictive value was 93 %. By using the best cut-off point (MNA score of 22 according to Youden index), the sensitivity, specificity, positive-predictive value and negative-predictive value were 88 %, 62 %, 57 % and 89 %, respectively.

CONCLUSIONS

The MNA with its established cut-off points may not be a good fit for Asian populations, including Iranian elderly.

摘要

目的

确定微型营养评估（MNA）能否对伊朗老年人进行营养不良的筛查和诊断。

设计

对所有志愿者进行 MNA 评估。每位患者均接受人体测量学和血清白蛋白测量。评估了可靠性、有效性、敏感性、特异性、阳性和阴性预测值。为了确定预测营养不良的最佳阈值值，对 MNA 评分进行了受试者工作特征曲线分析。

地点

卡里扎克慈善基金会（德黑兰，伊朗）。

对象

221 例连续老年患者纳入横断面研究。排除截肢患者和患有肝或肾功能障碍、水肿或任何终末期疾病的患者。

结果

根据 MNA 评分，3.2%的患者存在营养不良，43.4%的患者存在营养不良风险，53.4%的患者营养良好。根据理想体重和血清白蛋白，这些类别的比例分别为 2.3%、17.1%和 80.6%。克朗巴赫α系数（可靠性）为 0.61。MNA 总分与人体测量值和血清白蛋白之间的相关性（效标关联效度）均具有统计学意义。在两个 BMI 组之间，MNA 总分存在显著差异，但在根据血清白蛋白和皮肤溃疡进行分类的两组之间不存在显著差异（结构效度）。根据其既定切点，MNA 的敏感性和特异性分别为 82%和 63%。阳性预测值为 35%，阴性预测值为 93%。使用最佳切点（根据 Youden 指数的 MNA 评分 22），敏感性、特异性、阳性预测值和阴性预测值分别为 88%、62%、57%和 89%。