De Morais M B, Fagundes Neto U, Baruzzi R G, Prado M C, Wehba J, Silvestrini W S
Disciplina de Gastrenterologia Pediátrica da EPM, São Paulo.
Rev Paul Med. 1990 Nov-Dec;108(6):245-51.
The purpose of this study was to determine the presence of malnutrition in indian children of Alto Xingu region in Brazil, and to evaluate the usefulness of arm circumference and QUAC index in the diagnosis of protein-energy malnutrition (PEM). SITE: The indian population of Alto Xingu maintains most of its traditional customs.
335 children were studied prospectively in at least one of seven consecutive years between 1974 and 1980, and 1278 measurements were obtained of weight, height, and arm circumference.
The annual prevalence of PEM (weight-for-height) less than 90% according to Brazilian reference tables was 4.1% in children aged under 1 year, 7.3% in children from 1 to 5 years of age, and 7.5% in children older than 5. According NCHS tables, however, values of 1.0%, 2.8%, and 1.1% were obtained for the respective age groups. The sensitivity and specificity of arm circumference and QUAC index were calculated in relation to the weight-for-height relation. According to Brazilian reference tables, arm circumference had a sensitivity of 8.9% and specificity of 99.3%, whereas the QUAC index had a sensitivity of 11.1% and specificity of 98.3%. However, according to NCHS tables, slightly different values were obtained. The sensitivity and specificity in this case were 23.5% and 99.3%, respectively, for arm circumference and 35.3% and 98.3%, respectively, for the QUAC index.
The authors concluded that the prevalence of PEM was low in the Alto Xingu and that arm circumference and the QUAC index should only be used in situations suited to their sensitivity and specificity.
本研究旨在确定巴西阿尔托欣古地区印第安儿童中营养不良的存在情况,并评估臂围和QUAC指数在诊断蛋白质 - 能量营养不良(PEM)中的效用。研究地点:阿尔托欣古的印第安人群保留了大部分传统习俗。
在1974年至1980年期间连续七年中的至少一年对335名儿童进行了前瞻性研究,共获得了1278次体重、身高和臂围测量数据。
根据巴西参考表,身高别体重低于90%的PEM年患病率在1岁以下儿童中为4.1%,1至5岁儿童中为7.3%,5岁以上儿童中为7.5%。然而,根据美国国家卫生统计中心(NCHS)的表格,各年龄组的相应数值分别为1.0%、2.8%和1.1%。计算了臂围和QUAC指数相对于身高别体重关系的敏感性和特异性。根据巴西参考表,臂围的敏感性为8.9%,特异性为99.3%,而QUAC指数的敏感性为11.1%,特异性为98.3%。然而,根据NCHS表格,得到了略有不同的值。在这种情况下,臂围的敏感性和特异性分别为23.5%和99.3%,QUAC指数的敏感性和特异性分别为35.3%和98.3%。
作者得出结论,阿尔托欣古地区PEM的患病率较低,臂围和QUAC指数仅应在适合其敏感性和特异性的情况下使用。