Zhu Yuan, Ye Hong, Feng Yi, Pan Li-Ya, Fu Huan-Huan, Liu Yun-Man, Fei Jun, Hong Li
Department of Clinical Nutrition, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Paediatric, Fujian Province Children's Hospital, Fujian Provincial Maternity and Children's Hospital, Fujian Medical University, Fujian, China.
J Paediatr Child Health. 2021 Aug;57(8):1274-1280. doi: 10.1111/jpc.15450. Epub 2021 Mar 22.
To investigate paediatric outpatients' nutritional status using bioelectrical impedance analysis and anthropometric z-scores.
A retrospective data analysis of tertiary paediatric hospital outpatients from 2017 to 2019 was conducted. Patients were categorised into three groups (non-illness, illness and simple obesity) according to clinical diagnoses. The nutritional status was evaluated using anthropometric and bioelectrical impedance analysis. In addition, body composition measurements of patients in three subgroups of the illness group and age- and gender-matched healthy controls were compared.
A total of 2015 paediatric outpatients were enrolled. According to body mass index z-scores, undernutrition prevalence among participants was 14.0% (non-illness group, 21.3%; illness group, 11.4%). Body composition measurements indicated that 41.6% of participants had a low fat-free mass index, and the proportions of participants with a low fat-free mass index in the non-illness, illness and simple obesity groups were 48.4, 47.0 and 10.7%, respectively. Compared with healthy controls, the haematology and oncology subgroup had a significantly lower fat-free mass index and fat mass index; the nephrology and rheumatology subgroup had significantly lower height-for-age z-scores but higher fat mass index; and the gastroenterology subgroups had lower fat mass index, fat-free mass index and body mass index z-scores.
The results suggested the low fat-free mass index prevalence was greater than the low body mass index z-score prevalence among paediatric outpatients, and body composition parameters varied across different illnesses. Body composition analysis is recommended in nutrition clinics for accurate paediatric outpatient nutritional assessment, thereby providing timely individualised nutritional interventions.
采用生物电阻抗分析和人体测量Z评分来调查儿科门诊患者的营养状况。
对2017年至2019年三级儿科医院门诊患者进行回顾性数据分析。根据临床诊断将患者分为三组（非疾病组、疾病组和单纯肥胖组）。采用人体测量和生物电阻抗分析评估营养状况。此外，还比较了疾病组三个亚组患者与年龄和性别匹配的健康对照者的身体成分测量结果。
共纳入2015名儿科门诊患者。根据体重指数Z评分，参与者中营养不良患病率为14.0%（非疾病组为21.3%；疾病组为11.4%）。身体成分测量表明，41.6%的参与者脂肪量指数较低，非疾病组、疾病组和单纯肥胖组中脂肪量指数较低的参与者比例分别为48.4%、47.0%和10.7%。与健康对照者相比，血液学和肿瘤学亚组的脂肪量指数和去脂体重指数显著较低；肾病和风湿病亚组的年龄别身高Z评分显著较低，但脂肪量指数较高；胃肠病学亚组的脂肪量指数、去脂体重指数和体重指数Z评分较低。
结果表明，儿科门诊患者中去脂体重指数低的患病率高于体重指数Z评分低的患病率，且不同疾病的身体成分参数有所不同。建议在营养门诊进行身体成分分析，以准确评估儿科门诊患者的营养状况，从而及时提供个性化营养干预。
