Penn State University, University Park, PA, USA.
JPEN J Parenter Enteral Nutr. 2010 Mar-Apr;34(2):156-9. doi: 10.1177/0148607110361910.
BACKGROUND & AIMS: Multiple definitions for malnutrition syndromes are found in the literature resulting in confusion. Recent evidence suggests that varying degrees of acute or chronic inflammation are key contributing factors in the pathophysiology of malnutrition that is associated with disease or injury.
An International Guideline Committee was constituted to develop a consensus approach to defining malnutrition syndromes for adults in the clinical setting. Consensus was achieved through a series of meetings held at the A.S.P.E.N. and ESPEN Congresses.
It was agreed that an etiology-based approach that incorporates a current understanding of inflammatory response would be most appropriate. The Committee proposes the following nomenclature for nutrition diagnosis in adults in the clinical practice setting. "Starvation-related malnutrition", when there is chronic starvation without inflammation, "chronic disease-related malnutrition", when inflammation is chronic and of mild to moderate degree, and "acute disease or injury-related malnutrition", when inflammation is acute and of severe degree.
This commentary is intended to present a simple etiology-based construct for the diagnosis of adult malnutrition in the clinical setting. Development of associated laboratory, functional, food intake, and body weight criteria and their application to routine clinical practice will require validation.
文献中存在多种营养不良综合征的定义，导致混淆。最近的证据表明，不同程度的急性或慢性炎症是营养不良病理生理学的关键致病因素，而营养不良与疾病或损伤有关。
成立了一个国际指南委员会，以制定一种共识方法来定义临床环境中的成人营养不良综合征。通过在 ASPEN 和 ESPEN 大会上举行的一系列会议达成了共识。
大家一致认为，采用病因为基础的方法，并结合对炎症反应的当前理解，是最合适的。委员会建议在临床实践环境中对成人进行营养诊断使用以下命名法。“饥饿相关性营养不良”，即存在慢性饥饿而无炎症；“慢性疾病相关性营养不良”，即炎症为慢性且轻度至中度；“急性疾病或损伤相关性营养不良”，即炎症为急性且严重程度。
本评论旨在为临床环境中成人营养不良的诊断提供一种简单的基于病因的方法。相关实验室、功能、食物摄入和体重标准的制定及其在常规临床实践中的应用需要验证。
