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中国HIV患者中一项六项膳食钙筛查工具的验证

Validation of a six-item dietary calcium screening tool among HIV patients in China.

作者信息

Tseng Leslie Yingzhijie, Xie Wenni, Pan Wei, Lyu Hui, Yu Zhangping, Shi Wenyan, He Yun, Chen Wei, Li Taisheng, Hsieh Evelyn

机构信息

Yale School of Medicine, New Haven, CT, USA.

Department of Parenteral and Enteral Nutrition, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, 1 Shuaifuyuan, Dongcheng District, Beijing, China.

出版信息

Public Health Nutr. 2021 Oct;24(15):4786-4795. doi: 10.1017/S1368980021001427. Epub 2021 Apr 6.

Abstract

OBJECTIVE

Individuals with HIV are at increased risk for osteoporosis. A healthy diet with adequate Ca is recommended to promote bone health. However, lengthy nutritional assessments pose barriers to routine screenings in clinical practice. This study aimed to examine the validity and reproducibility of a six-item dietary Ca screening tool among Chinese individuals with HIV.

DESIGN

We conducted a two time-point study in an outpatient setting. Volunteers self-administered the six-item tool upon enrolment and again at 1-month follow-up. At baseline, participants also completed a validated FFQ and surveys regarding demographic and clinical risk factors.

SETTING

Beijing, China; Shenzhen, Guangdong, China.

PARTICIPANTS

Upon enrolment, 127 individuals with HIV participated in the study, of whom 83 completed the follow-up screening.

RESULTS

Mean age of participants was 35·2 (sd 9·3) years, average BMI was 22·8 (sd 3·8) kg/m2 and 89 % were men. Among the participants, 54·7 % reported Ca intake less than 800 mg/d. The six-item tool demonstrated fair-to-moderate relative validity with a correlation of 0·39 and 75·7 % of subjects classified in same/adjacent quartiles as the reference, and moderate-to-good reproducibility with a correlation of 0·60 and 83·1 % of subjects classified in same/adjacent quartiles. Finally, receiver operating characteristic analyses yielded a sensitivity of 87·0 % and a specificity of 39·4 % with optimised cut-off level.

CONCLUSIONS

The six-item tool presented adequate validity and reproducibility to identify individuals with low Ca intake among the target population, providing a convenient instrument for categorising Ca intake in clinical practice, prompting referrals for further assessment, and raising awareness of dietary Ca in bone disease prevention.

摘要

目的

感染人类免疫缺陷病毒(HIV)的个体患骨质疏松症的风险增加。建议通过健康饮食摄入足够的钙以促进骨骼健康。然而,冗长的营养评估给临床实践中的常规筛查带来了障碍。本研究旨在检验一项包含六个条目的饮食钙筛查工具在感染HIV的中国个体中的有效性和可重复性。

设计

我们在门诊环境中进行了一项两时间点研究。志愿者在入组时以及1个月随访时自行填写这一包含六个条目的工具。在基线时,参与者还完成了一份经过验证的食物频率问卷以及关于人口统计学和临床风险因素的调查。

地点

中国北京;中国广东深圳。

参与者

入组时,127名感染HIV的个体参与了本研究,其中83人完成了随访筛查。

结果

参与者的平均年龄为35.2(标准差9.3)岁,平均体重指数为22.8(标准差3.8)kg/m²,89%为男性。在参与者中,54.7%报告钙摄入量低于800mg/天。该包含六个条目的工具显示出中等相对有效性,相关性为0.39,75.7%的受试者被归类于与参考值相同/相邻的四分位数区间,并且具有中等至良好的可重复性,相关性为0.60,83.1%的受试者被归类于相同/相邻的四分位数区间。最后,受试者工作特征分析得出,在优化的截断水平下,灵敏度为87.0%,特异性为39.4%。

结论

该包含六个条目的工具在识别目标人群中钙摄入量低的个体方面具有足够的有效性和可重复性,为临床实践中对钙摄入量进行分类、促使进一步评估转诊以及提高对饮食钙在预防骨病方面的认识提供了一种便捷工具。

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