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在全科医疗中通过非故意体重减轻来衡量营养不良。

Malnutrition measured by unintended weight loss among patients in general practice.

机构信息

Center for Nutrition and Intestinal Failure, Aalborg University Hospital, Aalborg, Denmark.

Center for Nutrition and Intestinal Failure, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Sciences, Aalborg University, Aalborg, Denmark.

出版信息

Nutrition. 2022 Apr;96:111554. doi: 10.1016/j.nut.2021.111554. Epub 2021 Nov 30.

Abstract

OBJECTIVE

Disease-related malnutrition should be managed before negative consequences occur. The aim of this study was to investigate the prevalence of unintended weight loss and reduced food intake among patients ≥18 y of age attending a general practice.

METHODS

All patients visiting five general practices in Denmark, for 4 d in each place, were invited to participate in this questionnaire-based cross-sectional study. The questionnaire consisted of eight questions including unintended weight loss within the previous 2 mo, reduced food intake within the previous week, and symptoms that affected nutrition. Descriptive statistics, χ tests, and simple and multivariable logistic regression analysis were performed. The study included 1087 patients with an 88.7% response rate.

RESULTS

Unintended weight loss was found in 14.2% and 12.9% had reduced food intake. Of the patients with unintended weight loss, 62.3% also had reduced food intake. Patients 18 to 39 and >80 y of age; underweight patients; and patients visiting general practice for chronic pain, mental discomfort, and suspicion of serious illness had significantly higher odds for unintended weight loss and reduced food intake. Patients with reduced food intake had higher odds for unintended weight loss, and those visiting the general practice due to fatigue had higher odds for reduced food intake. Patients in obesity class 1 to 3 and patients who had come for a general health checkup had lower odds. Patients visiting for follow-up on chronic physical illness had higher odds of having unintended weight loss and reduced food intake combined.

CONCLUSION

Overall, 14.2% of the patients had unintended weight loss, 12.9% had reduced food intake, and 62.3% had both, indicating a high prevalence of unintended weight loss among patients in general practice. Unintended weight loss seems relevant and feasible to use as an initial indicator for the need for further nutritional screening in general practice. Studies are needed to investigate the effect of interventions and outcomes.

摘要

目的

疾病相关营养不良应在产生不良后果之前得到处理。本研究旨在调查在丹麦五家普通诊所就诊的≥18 岁患者中,出现非预期体重减轻和食物摄入减少的患病率。

方法

所有患者均应邀参加这项基于问卷调查的横断面研究,在丹麦五个普通诊所各连续 4 天就诊。问卷包括 8 个问题,包括过去 2 个月内非预期体重减轻、过去一周内食物摄入减少以及影响营养的症状。采用描述性统计、χ检验、简单和多变量逻辑回归分析。本研究共纳入 1087 例患者,应答率为 88.7%。

结果

14.2%的患者出现非预期体重减轻,12.9%的患者食物摄入减少。在出现非预期体重减轻的患者中,62.3%的患者同时存在食物摄入减少。18 至 39 岁和>80 岁的患者;体重不足的患者;以及因慢性疼痛、精神不适和怀疑严重疾病就诊的患者,出现非预期体重减轻和食物摄入减少的可能性显著更高。存在食物摄入减少的患者出现非预期体重减轻的可能性更高,因疲劳就诊的患者出现食物摄入减少的可能性更高。体重指数 1 至 3 级的患者和进行常规健康检查的患者出现这种情况的可能性较低。因慢性躯体疾病复诊的患者出现非预期体重减轻和食物摄入减少的可能性更高。

结论

总体而言,14.2%的患者出现非预期体重减轻,12.9%的患者出现食物摄入减少,62.3%的患者同时存在这两种情况,这表明普通诊所患者中出现非预期体重减轻的情况较为普遍。非预期体重减轻似乎可以作为在普通诊所进一步进行营养筛查的初始指标,且具有相关性和可行性。需要开展研究来调查干预措施和结果的影响。

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