de Luis D A, Izaola O, López L, Blanco B, Colato C A, Kelly O J, Sanz R
Centro de Investigación de Endocrinología y Nutrición Clínica Facultad de Medicina, Servicio de Endocrinología y Nutrición Hospital Clínico Valladolid, Av. Ramón y Cajal, 3, 47003, Valladolid, Spain.
Hospital San Juan, Alicante, Spain.
Eur Geriatr Med. 2018;9(6):809-817. doi: 10.1007/s41999-018-0109-4. Epub 2018 Nov 16.
To evaluate the effectiveness of a high calorie and protein, β-hydroxy-β-methylbutyrate containing oral nutritional supplement (HP-HMB-ONS), on nutritional status, activities of daily living and quality of life (QoL) in old malnourished subjects.
We conducted an observational, prospective, open label, multicenter study. Participants were > 65 years, undernourished or at nutritional risk [Nutrition Risk Score (NRS) ≥ 3] and had been included on an ONS (HP-HMB-ONS twice daily for 12 weeks) per standard of care. Visits at baseline (V1), 6 weeks (V2) and 12 weeks (V3) were performed. The primary endpoints were gain of body weight, change in body mass index (BMI) and NRS 2002 index. Data from QoL (EQ-5D-3L) and activities of daily living (Katz index) were also collected.
A total of 235 participants were included in the study. Of these 148 took at least a 75% of the HP-HMB-ONS and were included in the analysis (per protocol); median age was 80.0 (SD:8.3) years, 65.5% ( = 97) were female, 67.6% ( = 100) had 2 or more diseases. At V3, a statistically significant increase in weight (2.1 kg; SD: 3.8) ( < 0.001) and BMI (0.8 kg/m; SD: 1.45) were found compared to V1, whereas NRS 2002 values decreased by 0.9 (SD: 1.2). A significant ( < 0.001) improvement in Katz index (mean change = 0.3; SD:1.4) and EQ-5D scoring (mean change = 0.5; SD:1.9) compared to V1, were also reported.
The results suggest that administration of a HP-HMB-ONS improve the nutritional status and may led to a significant improvement in patients' activities of daily living and QoL, independent of baseline BMI.
评估一种高热量、高蛋白且含β-羟基-β-甲基丁酸的口服营养补充剂(HP-HMB-ONS)对老年营养不良患者营养状况、日常生活活动能力和生活质量(QoL)的有效性。
我们开展了一项观察性、前瞻性、开放标签、多中心研究。参与者年龄>65岁,营养不良或存在营养风险[营养风险评分(NRS)≥3],并已按照标准护理方案纳入ONS(每天两次服用HP-HMB-ONS,共12周)。在基线(V1)、6周(V2)和12周(V3)进行访视。主要终点为体重增加、体重指数(BMI)变化和NRS 2002指数。还收集了生活质量(EQ-5D-3L)和日常生活活动能力(Katz指数)的数据。
共有235名参与者纳入研究。其中148人至少服用了75%的HP-HMB-ONS并纳入分析(符合方案);中位年龄为80.0(标准差:8.3)岁,65.5%(n = 97)为女性,67.6%(n = 100)患有2种或更多疾病。与V1相比,在V3时,体重(2.1 kg;标准差:3.8)(P<0.001)和BMI(0.8 kg/m²;标准差:1.45)有统计学显著增加,而NRS 2002值下降了0.9(标准差:1.2)。与V1相比Katz指数(平均变化=0.3;标准差:1.4)和EQ-5D评分(平均变化=0.5;标准差:1.9)也有显著(P<0.001)改善。
结果表明,服用HP-HMB-ONS可改善营养状况,并可能导致患者日常生活活动能力和生活质量显著改善,与基线BMI无关。