比较在埃塞俄比亚中北部博雷纳地区，人体测量学指标用于识别老年人营养不良状况的有效性：一项横断面研究。
Comparing the validity of anthropometric measurements in identifying malnutrition status of older age people in Borena district, North Central Ethiopia: a cross_sectional study.
机构信息
Dessie Comprehensive Specialized Hospital, Dessie, North Eastern, Ethiopia.
Human Nutrition and Dietetics Department, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.
出版信息
BMC Geriatr. 2022 Oct 3;22(1):776. doi: 10.1186/s12877-022-03467-9.
BACKGROUND
Malnutrition among older age people is becoming significantly higher in spite of improvements in the health care system. Life expectancy of Ethiopian elders is increasing; but reliable and valid tools for screening and diagnosis of malnutrition in this subgroup are limited. This study aimed to assess the validity of anthropometric measurements: Mid Upper Arm Circumference (MUAC), Body Mass Index (BMI), and Calf Circumference (CC) in detecting malnutrition status of older age people in Ethiopia.
METHODS
A community based cross-sectional study was conducted in Borena District from January to March, 2020. A total of 421 participants aged were systematically included in the study. To test reliability and validity of the measurements,Cronbach's α coefficient and Pearson's correlations were used, respectively. The full Mini-Nutritional Assessment (MNA) tool was used to diagnosis malnutrition. Overall accuracy, sensitivity and specificity of BMI, MUAC and CC were estimated using Receiver Operating Characteristic curves. The Youden Index was used to determine the best cut-off point.
RESULTS
The reliability of BMI, MUAC and CC by Cronbach's alpha was found 0.847. Significant positive correlations between MNA, BMI(r = 0.56, p < 0.01); MNA, MUAC(r = 0.43, p < 0.01; and MNA, CC(r = 0.52, p < 0.01) revealed. The area under the curve (AUC) of BMI, MUAC and CC were found: 0.98(95% CI, 0.96-0.99, p < 0.001), 0.94(95% CI, 0.89-0.98, p < 0.001) and 0.96(95% CI, 0.94-0.98, p < 0.001) indicating the overall accuracy respectively. The sensitivity and specificity of BMI, MUAC and CC using established cut off points were found: 90%, 96%; 78%, 94% and 84%, 95% respectively. However, using the Youden index the best cut-off point, the sensitivity and specificity of MUAC and CC were 88%, 86%; 92% and 89% respectively and adjusted for age and sex.
CONCLUSIONS
The current study demonstrated that BMI was a reliable and valid method to identify the malnutrition status of older age people. A MUAC value of 19 cm and CC of 30 cm were simple and efficient cut-off points for the determination of malnutrition in the older age people. A future study is needed to validate the validity of BMI, MUAC and CC against biochemical tests as gold standard.
背景
尽管医疗保健系统有所改善，但老年人的营养不良问题仍然显著增加。埃塞俄比亚老年人的预期寿命在增加；但是，对于这个亚组的筛查和诊断营养不良，可靠和有效的工具仍然有限。本研究旨在评估人体测量学测量：上臂中部周长（MUAC）、体重指数（BMI）和小腿围（CC）在检测埃塞俄比亚老年人营养不良状况方面的有效性。
方法
2020 年 1 月至 3 月在博莱纳区进行了一项基于社区的横断面研究。共有 421 名年龄在的参与者被系统纳入研究。为了测试测量的可靠性和有效性，分别使用 Cronbach's α 系数和 Pearson 相关性。使用完整的迷你营养评估（MNA）工具来诊断营养不良。使用接收者操作特征曲线估计 BMI、MUAC 和 CC 的总体准确性、敏感性和特异性。使用约登指数确定最佳截断点。
结果
Cronbach's alpha 发现 BMI、MUAC 和 CC 的可靠性为 0.847。MNA、BMI 之间存在显著正相关(r=0.56，p<0.01)；MNA、MUAC(r=0.43，p<0.01)；MNA、CC(r=0.52，p<0.01)。BMI、MUAC 和 CC 的曲线下面积（AUC）分别为：0.98(95% CI, 0.96-0.99, p<0.001)、0.94(95% CI, 0.89-0.98, p<0.001) 和 0.96(95% CI, 0.94-0.98, p<0.001)，表明总体准确性分别为。使用既定截断点的 BMI、MUAC 和 CC 的灵敏度和特异性分别为：90%、96%；78%、94%和 84%、95%。然而，使用约登指数最佳截断点，MUAC 和 CC 的灵敏度和特异性分别为 88%、86%；92%和 89%，并根据年龄和性别进行了调整。
结论
本研究表明，BMI 是一种可靠和有效的方法，可以识别老年人的营养不良状况。MUAC 值为 19cm 和 CC 值为 30cm 是确定老年人营养不良的简单有效截断点。需要进一步的研究来验证 BMI、MUAC 和 CC 与生化测试作为金标准的有效性。
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