Center for Geriatric Medicine (CEMI), Institute of Internal Medicine and Geriatrics, Catholic University of the Sacred Heart, Rome, Italy.
Abbott Nutrition, Research & Development, Granada, Spain.
Clin Nutr. 2019 Oct;38(5):2113-2120. doi: 10.1016/j.clnu.2018.11.021. Epub 2018 Nov 30.
Recent definitions of malnutrition include low muscle mass within its diagnostic criteria. In fact, malnutrition is one of the main risk factors of skeletal muscle loss contributing to the onset of sarcopenia. However, differences in the screening and diagnosis of skeletal muscle loss, especially as a result of malnutrition in clinical and community settings, still occur mainly as techniques and thresholds used vary in clinical practice. The objectives of this position paper are firstly to emphasize the link between skeletal muscle loss and malnutrition-related conditions and secondly to raise awareness for the timely identification of loss of skeletal muscle mass and function in high risk populations. Thirdly to recognize the need to implement appropriate nutritional strategies for prevention and treatment of skeletal muscle loss and malnutrition across the healthcare continuum. Malnutrition needs to be addressed clinically as a muscle-related disorder and clinicians should integrate nutritional assessment with muscle mass measurements for optimal evaluation of these two interrelated entities to tailor interventions appropriately. The design of monitoring/evaluation and discharge plans need to include multimodal interventions with nutrition and physical exercise that are key to preserve patient's muscle mass and function in clinical and community settings.
最近的营养不良定义包括其诊断标准中的低肌肉量。事实上，营养不良是导致肌肉减少症发生的主要骨骼肌肉丧失的风险因素之一。然而，由于在临床和社区环境中使用的技术和阈值不同，骨骼肌肉丧失的筛查和诊断仍然存在差异。本立场文件的目的首先是强调骨骼肌肉丧失与营养不良相关状况之间的联系，其次是提高对高危人群中骨骼肌肉质量和功能丧失的及时识别的认识。第三，认识到需要在整个医疗保健连续体中实施适当的营养策略，以预防和治疗骨骼肌肉丧失和营养不良。临床上需要将营养不良作为一种与肌肉相关的疾病来处理，临床医生应该将营养评估与肌肉质量测量相结合，以最佳评估这两个相互关联的实体，从而进行适当的干预。监测/评估和出院计划的设计需要包括多模式干预措施，包括营养和体育锻炼，这是在临床和社区环境中保留患者肌肉质量和功能的关键。
