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营养不良、肌肉减少症、肌少症性肥胖和肌少症性营养不良:全膝关节置换术前患者的横断面观察。

Undernutrition, Sarcopenia, Sarcopenic Obesity, and Sarcopenic Undernutrition: A Cross-sectional View on Patients Before Total Joint Arthroplasty.

机构信息

Matteo Briguglio, RDN, PhD, Laboratory of Nutritional Sciences, IRCCS Orthopedic Institute Galeazzi, Milan, Italy.

Paolo Sirtori, MD, E.U.O.R.R. Unit, IRCCS Orthopedic Institute Galeazzi, Milan, Italy.

出版信息

Orthop Nurs. 2024;43(5):276-283. doi: 10.1097/NOR.0000000000001058. Epub 2024 Sep 25.

Abstract

Diagnostic criteria of malnutrition phenotypes have been recently updated. Uncovering the prevalence of these conditions in patients undergoing hip replacement may be crucial in order to apply the most appropriate diagnostic-therapeutic paths to the right patient at the right time. Sixty patients aged between 60 and 85 undergoing elective hip replacement were recruited. Preoperative measures concerning eating behaviors, anthropometry, physical performance, laboratory parameters, and patient reported measures of pain and function were collected, used to make diagnosis, and explored whether they differed based on malnutrition categorization. Patients undernourished were 18.75%, sarcopenic 13.34%, sarcopenic obesity 4.26%, and 8.88% undernourished and sarcopenic. Well-nourished patients ate more cereals and meat, exhibited lower white blood cells but higher lymphocytes, and reported greater hip-related pain. One in three older patients undergoing elective hip replacement was malnourished. Eating behaviors and leucocytes were the discriminating factors between malnourished and well-nourished. It remains to be established whether malnutrition affects outcome after surgery.

摘要

营养不良表型的诊断标准最近已经更新。在接受髋关节置换术的患者中发现这些情况的患病率可能至关重要,以便在正确的时间为正确的患者应用最合适的诊断-治疗路径。我们招募了 60 名年龄在 60 岁至 85 岁之间的择期髋关节置换术患者。收集了与饮食行为、人体测量学、身体表现、实验室参数以及患者报告的疼痛和功能测量相关的术前措施,用于做出诊断,并探讨它们是否根据营养不良分类而有所不同。营养不良的患者占 18.75%,肌少症患者占 13.34%,肌少症合并肥胖的患者占 4.26%,营养不良合并肌少症的患者占 8.88%。营养良好的患者食用更多的谷物和肉类,白细胞较低但淋巴细胞较高,髋关节相关疼痛报告也较大。三分之一接受择期髋关节置换术的老年患者存在营养不良。饮食行为和白细胞是区分营养不良和营养良好的因素。营养不良是否会影响手术后的结果仍有待确定。

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