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评估类风湿关节炎和脊柱关节炎的营养状况及识别营养风险的方法。

Evaluation of Nutritional Status and Methods to Identify Nutritional Risk in Rheumatoid Arthritis and Spondyloarthritis.

机构信息

Mohn Nutrition Research Laboratory, Department of Clinical Medicine, Faculty of Medicine, University of Bergen, P.O. Box 7804, 5020 Bergen, Norway.

Department of Rheumatology, Haukeland University Hospital, 5021 Bergen, Norway.

出版信息

Nutrients. 2020 Nov 21;12(11):3571. doi: 10.3390/nu12113571.

Abstract

Patients with rheumatoid arthritis (RA) and spondyloarthritis (SpA) experience several nutritional challenges and are prone to develop malnutrition. This observational study aimed to perform a comprehensive nutritional assessment of outpatients diagnosed with RA and SpA, as well as to evaluate methods to identify nutritional risk. Nutritional status was investigated by anthropometric measures, body composition (DXA, dual energy X-ray absorptiometry), and handgrip strength (HGS). Nutritional risk was classified by Nutritional Risk Screening 2002 (NRS2002) and malnutrition was defined by the Global Leadership Initiative on Malnutrition (GLIM) criteria and fat-free mass index (FFMI; kg/m, <16.7 (M), <14.6 (F)). Out of 71 included patients, 46 (66%) were abdominally obese, 28 (39%) were obese in terms of body mass index (BMI), and 33 (52%) were obese in terms of the fat mass index (FMI; kg/m, ≥8.3 (M), ≥11.8 (F)). Malnutrition was identified according to FFMI in 12 (19%) patients, according to GLIM criteria in 5 (8%) patients, and on the basis of BMI (<18.5 kg/m) in 1 (1%) patient. None were identified by NRS2002 to be at nutritional risk. Our study revealed high prevalence of abdominal obesity and low FFMI. Waist circumference was a good indicator of FMI. BMI, NRS2002, and HGS did not capture patients with malnutrition identified by DXA.

摘要

类风湿关节炎(RA)和脊柱关节炎(SpA)患者存在多种营养挑战,易发生营养不良。本观察性研究旨在对诊断为 RA 和 SpA 的门诊患者进行全面的营养评估,并评估识别营养风险的方法。通过人体测量学指标、身体成分(DXA、双能 X 射线吸收法)和握力(HGS)评估营养状况。采用营养风险筛查 2002 版(NRS2002)进行营养风险分类,采用全球营养不良倡议(GLIM)标准和去脂体重指数(FFMI;kg/m,<16.7(M),<14.6(F))定义营养不良。在纳入的 71 例患者中,46 例(66%)存在腹部肥胖,28 例(39%)存在 BMI 肥胖,33 例(52%)存在 FMI 肥胖(kg/m,≥8.3(M),≥11.8(F))。根据 FFMI 确定 12 例(19%)患者存在营养不良,根据 GLIM 标准确定 5 例(8%)患者存在营养不良,根据 BMI(<18.5 kg/m)确定 1 例(1%)患者存在营养不良。没有患者根据 NRS2002 被识别为存在营养风险。本研究显示出高比例的腹部肥胖和低 FFMI。腰围是 FMI 的良好指标。BMI、NRS2002 和 HGS 无法捕获 DXA 确定的营养不良患者。

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