炎症和营养状况作为住院期间身体机能和力量丧失的预测指标。
Inflammation and nutritional status as predictors of physical performance and strength loss during hospitalization.
作者信息
Rossi A P, Zanandrea V, Zoico E, Zanardo M, Caliari C, Confente S, Gabriele S, Mazzali G, Fantin F, Zamboni M
机构信息
Section of Geriatrics, Department of Medicine, Division of Geriatrics, University of Verona, Verona, Italy.
出版信息
Eur J Clin Nutr. 2016 Dec;70(12):1439-1442. doi: 10.1038/ejcn.2016.159. Epub 2016 Aug 31.
OBJECTIVES
The aim of this study was to examine changes in physical performance and handgrip strength during hospitalization as well as to evaluate their interrelationship with inflammatory and nutritional status.
DESIGN
Data were available on 302 elderly patients with a mean age of 80.83±7.14 years. Handgrip strength, gait speed and chair-stand test were assessed at admission and before discharge. In all subjects, serum CRP values and Mini Nutritional Assessment scores were also evaluated.
RESULTS
The risk of worsening in chair-stand test performance was 4.2 (95% confidence interval (CI): 1.574-11.310) for subjects with simultaneous presence of malnutrition and CRP⩾50 and 3.3 mg/dl (95% CI: 1.127-9.423) for subjects with CRP⩾50 mg/l not malnourished in comparison with subjects with Mini Nutritional Assessment (MNA)⩾24 and CRP⩽10 mg/l. The risk of handgrip strength loss was 8.8 (95% CI: 3.545-21.662) in subjects with simultaneous presence of malnutrition and CRP⩾50 and 2.9 mg/dl (95% CI: 1.223-6.783) in subjects with CRP⩾50 mg/l not malnourished in comparison with subjects with MNA⩾24 and CRP⩽10 mg/l.
CONCLUSIONS
Simultaneous presence of high CRP values and malnutrition determines an additive effect on muscle strength loss and physical performance.
目的
本研究旨在探讨住院期间身体机能和握力的变化，并评估它们与炎症和营养状况之间的相互关系。
设计
研究纳入了302例老年患者，平均年龄为80.83±7.14岁。在入院时和出院前评估握力、步速和从椅子上站起测试。所有受试者均评估血清CRP值和简易营养评估分数。
结果
与简易营养评估（MNA）≥24且CRP≤10mg/L的受试者相比，同时存在营养不良且CRP≥50的受试者从椅子上站起测试表现恶化的风险为4.2（95%置信区间（CI）：1.574 - 11.310），CRP≥50mg/L但未营养不良的受试者该风险为3.3mg/dl（95%CI：1.127 - 9.423）。与MNA≥24且CRP≤10mg/L的受试者相比，同时存在营养不良且CRP≥50的受试者握力丧失风险为8.8（95%CI：3.545 - 21.662），CRP≥50mg/L但未营养不良的受试者该风险为2.9mg/dl（95%CI：1.223 - 6.783）。
结论
高CRP值和营养不良同时存在会对肌肉力量丧失和身体机能产生累加效应。
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