González Madroño A, Mancha A, Rodríguez F J, de Ulibarri J I, Culebras J
Sección de Nutrición Clínica y Dietética, Hospital Universitario de La Princesa, Madrid, España.
Nutr Hosp. 2011 May-Jun;26(3):594-601. doi: 10.1590/S0212-16112011000300024.
To evaluate the relationship between serum albumin, total cholesterol and total lymphocyte count with two nutritional assessment methods, to verify if their use is justified in nutritional screening tools.
101 patients admitted to medical/surgical wards underwent the SGA and the Full Nutritional Assessment (FNA). Blood test which included serum albumin, total cholesterol and total lymphocyte count (TLC), were made. Percentage of weight loss and BMI were calculated. An Anova test was done to measure the differences in the mean levels of the three parameters for the nutritional status evaluated by SGA and FNA. The probability of a patient being malnourished in the four ranges established for each parameter was calculated, as well as the relationship between the ranges and the percentage of weight loss and BMI. Sensitivity and specificity were calculated and the corresponding ROC curves, using SGA as gold standard.
Prevalence of undernutrition is 43.6% and 44.6% for SGA and FNA respectively. Mean levels of the three parameters decrease as the undernutrition degree increases (p < 0.005 for all cases). The probability of a patient being malnourished gets higher as parameter lowers (p = 0.000 for all cases). Total cholesterol shows a relationship with BMI < 18.5 and presence/absence of weight loss (p = 0.074 and p = 0.002 respectively). The area under ROC curves are albumin (0.823), cholesterol (0.790) and TLC (0.758) respectively.
The analytical parameters analyzed show a statistically significant relationship with the nutritional status. Therefore, they are suitable for use in nutritional screening.
采用两种营养评估方法评估血清白蛋白、总胆固醇和淋巴细胞总数之间的关系，以验证它们在营养筛查工具中的应用是否合理。
对101名入住内科/外科病房的患者进行主观全面评定法（SGA）和全面营养评估（FNA）。进行包括血清白蛋白、总胆固醇和淋巴细胞总数（TLC）的血液检测。计算体重减轻百分比和体重指数（BMI）。进行方差分析以测量通过SGA和FNA评估的营养状况下三个参数平均水平的差异。计算每个参数设定的四个范围内患者营养不良的概率，以及范围与体重减轻百分比和BMI之间的关系。以SGA作为金标准计算敏感性和特异性以及相应的ROC曲线。
SGA和FNA的营养不良患病率分别为43.6%和44.6%。随着营养不良程度的增加，三个参数的平均水平降低（所有情况p<0.005）。随着参数降低，患者营养不良的概率增加（所有情况p = 0.000）。总胆固醇与BMI<18.5以及体重减轻的存在与否相关（分别为p = 0.074和p = 0.002）。ROC曲线下面积分别为白蛋白（0.823）、胆固醇（0.790）和TLC（0.758）。
所分析的分析参数与营养状况显示出统计学上的显著关系。因此，它们适用于营养筛查。
