Alamri Sultan H, Simbawa Mayar M
Department of Family Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
Neuroscience and Geroscience Research Unit, King Fahd Medical Research Center, Abdulaziz University, Jeddah, Saudi Arabia.
Front Med (Lausanne). 2024 Jul 23;11:1436977. doi: 10.3389/fmed.2024.1436977. eCollection 2024.
Malnutrition is prevalent among hospitalized older patients. Early identification is therefore essential to implementing appropriate therapeutic interventions. This study aimed to explore the correlation between handgrip strength (HGS) and nutritional status in hospitalized older adults.
This observational cross-sectional study was conducted at King Abdulaziz University Hospital, where a consecutive cohort of older adult inpatients was enrolled for participation. Shortly after admission, HGS and nutritional status were assessed using a dynamometer and the most recent version of the Mini-Nutritional Assessment Short Form (MNA-SF) test, respectively. Key anthropometric and biochemical indicators were also collected.
A total of 135 consecutive patients were evaluated. Among participants with low HGS, 18 (16.22%) were malnourished, 43 (38.74%) were at risk of malnutrition, and 50 (45.05%) had normal nutrition status. The participants with low HGS had low hemoglobin, low lymphocyte levels, high creatinine levels, high BUN levels, high CRP levels, high HbA1c levels, and high vitamin B12 levels. Multiple logistic regression analysis showed that age, hemoglobin, and HbA1C were independently associated with low HGS. Based on the cut-off values for the HGS by the European Working Group on Sarcopenia in Older People-2 (EWGSOP2), low HGS showed high sensitivity to detect "malnourished and at risk of malnutrition" as well as "malnourished alone;" however, the specificity was low to exclude "malnourished and at risk of malnutrition" as well as "malnutrition alone."
Age over 75 years, low hemoglobin, and elevated HbA1C levels were independent risk factors for low HGS. While HGS was sensitive in detecting malnutrition or risk, its specificity was low. Therefore, HGS may not be adequate as a standalone tool to assess nutritional status in hospitalized older adults. Replication of this study using locally reliable and validated HGS cut-off values is warranted to confirm these findings.
营养不良在住院老年患者中普遍存在。因此，早期识别对于实施适当的治疗干预至关重要。本研究旨在探讨住院老年人握力（HGS）与营养状况之间的相关性。
本观察性横断面研究在阿卜杜勒阿齐兹国王大学医院进行，连续纳入一组老年住院患者参与研究。入院后不久，分别使用测力计和最新版简易营养评估量表（MNA-SF）评估握力和营养状况。还收集了关键的人体测量和生化指标。
共评估了135例连续患者。在握力较低的参与者中，18例（16.22%）营养不良，43例（38.74%）存在营养不良风险，50例（45.05%）营养状况正常。握力较低的参与者血红蛋白水平低、淋巴细胞水平低、肌酐水平高、尿素氮水平高、C反应蛋白水平高、糖化血红蛋白水平高、维生素B12水平高。多因素逻辑回归分析显示，年龄、血红蛋白和糖化血红蛋白与低握力独立相关。根据老年人肌少症欧洲工作组-2（EWGSOP2）的握力临界值，低握力对检测“营养不良和有营养不良风险”以及“单独营养不良”具有较高敏感性；然而，排除“营养不良和有营养不良风险”以及“单独营养不良”的特异性较低。
75岁以上、低血红蛋白和糖化血红蛋白水平升高是低握力的独立危险因素。虽然握力在检测营养不良或风险方面具有敏感性，但其特异性较低。因此，握力可能不足以作为评估住院老年人营养状况的独立工具。有必要使用当地可靠且经过验证的握力临界值重复本研究以证实这些发现。
