Ozer Nurhayat Tugra, Akin Sibel, Gunes Sahin Gulsah, Sahin Serap
Department of Clinical Nutrition, Erciyes School of Medicine, Erciyes University, Kayseri, Turkey.
Division of Geriatrics, Department of Internal Medicine, Erciyes School of Medicine, Erciyes University, Kayseri, Turkey.
JPEN J Parenter Enteral Nutr. 2022 Feb;46(2):367-377. doi: 10.1002/jpen.2123. Epub 2021 May 27.
The Global Leadership Initiative on Malnutrition (GLIM) published malnutrition identification criteria. The Mini Nutritional Assessment (MNA) is malnutrition assessment tool commonly used in older adults. This study aimed to determine prevalence of malnutrition and the relationship between the GLIM and the MNA long form (MNA-LF) and short form (MNA-SF) and energy-protein intake.
A total of 252 older adult outpatients (aged 68.0 years, 61% females) were included. Malnutrition was defined according to the GLIM, MNA-LF, and MNA-SF. Food intake was assessed using the 24-h dietary recall. We analyzed the cutoff value on the MNA-LF score, MNA-SF score, and energy-protein intake for GLIM criteria-defined malnutrition severity with receiver operating characteristic analysis.
Malnutrition was present in 32.2%, 12.7%, and 13.1% of patients according to the GLIM criteria, MNA-LF, and MNA-SF, respectively. It was determined that 92.7% and 89.0% of patients, based on GLIM criteria, had malnutrition with the MNA-LF and MNA-SF, respectively. The daily energy-protein intake was less in patients with malnutrition according to GLIM, as in the MNA-LF and MNA-SF classifications (p < .05). For the MNA-LF and MNA-SF score, the cutoff value of 11 and 9 points for severe malnutrition (area under curve [AUC] 0.92; p < .001 and 0.90; p < .001), 22 and 11 points for moderate malnutrition (AUC 0.79; p < .001 and 0.76; p < .001) were determined.
According to GLIM criteria, one-third of outpatient older adults were malnourished, whereas the prevalence was much lower applying both the MNA-LF and the MNA-SF.
全球营养不良领导倡议组织(GLIM)发布了营养不良识别标准。微型营养评定法(MNA)是老年人常用的营养不良评估工具。本研究旨在确定营养不良的患病率以及GLIM与MNA长表(MNA-LF)、短表(MNA-SF)和能量-蛋白质摄入量之间的关系。
共纳入252名老年门诊患者(年龄68.0岁,61%为女性)。根据GLIM、MNA-LF和MNA-SF定义营养不良。采用24小时膳食回顾法评估食物摄入量。我们通过受试者工作特征分析,分析了MNA-LF评分、MNA-SF评分以及能量-蛋白质摄入量对于GLIM标准定义的营养不良严重程度的截断值。
根据GLIM标准、MNA-LF和MNA-SF,分别有32.2%、12.7%和13.1%的患者存在营养不良。根据GLIM标准,分别有92.7%和89.0%的患者通过MNA-LF和MNA-SF判定为营养不良。与MNA-LF和MNA-SF分类情况相同,根据GLIM标准,营养不良患者的每日能量-蛋白质摄入量较少(p < 0.05)。对于MNA-LF和MNA-SF评分,确定严重营养不良的截断值为11分和9分(曲线下面积[AUC]分别为0.92;p < 0.001和0.90;p < 0.001),中度营养不良的截断值为22分和11分(AUC分别为0.79;p < 0.001和0.76;p < 0.001)。
根据GLIM标准,三分之一的老年门诊患者存在营养不良,而应用MNA-LF和MNA-SF时患病率则低得多。