您的位置:山东大学 -> 科技期刊社 -> 《山东大学学报(医学版)》

山东大学学报(医学版) ›› 2017, Vol. 55 ›› Issue (11): 65-70.doi: 10.6040/j.issn.1671-7554.0.2017.107

• 公共卫生与管理学 • 上一篇    下一篇

利用微型营养评价法和微型营养评价精法评价社区老年人的营养状况

张欢欢1,王翠平1,赵敏1,郭冬梅1,陈立勇2,蔺新英1   

  1. 1.山东大学公共卫生学院营养与食品卫生学研究所, 山东 济南 250012;2.山东大学附属省立医院营养科, 山东 济南 250021
  • 收稿日期:2017-02-02 出版日期:2017-11-10 发布日期:2017-11-10
  • 通讯作者: 蔺新英. E-mail:xinyingll@sdu.edu.cn E-mail:xinyingll@sdu.edu.cn
  • 基金资助:
    科技部基础专项(2015FY111600)

Mini-Nutritional Assessment and Short-Form Mini-Nutritional Assessment in evaluating nutritional status of the elderly in community

ZHANG Huanhuan1, WANG Cuiping1, ZHAO Min1, GUO Dongmei1, CHEN Liyong2, LIN Xinying1   

  1. 1. Institution of Nutrition and Food Hygiene, School of Public Health, Shandong University, Jinan 250012, Shandong, China;
    2. Department of Nutrition, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, Shandong, China
  • Received:2017-02-02 Online:2017-11-10 Published:2017-11-10

摘要: 目的 利用微型营养评价法(MNA)和微型营养评价精法(MNA-SF)评价社区老年人的营养状况,比较二者在社区老年人营养状况评价中的应用价值。 方法 随机抽取济南市社区60岁及以上老年人576例,应用MNA和MNA-SF评价营养状况,并检测人体测量指标和实验室指标。 结果 MNA平均用时10 min,MNA-SF平均用时3 min。MNA测得的营养正常者所占比例为79.93%,潜在营养不良者占20.07%,未发现营养不良者。MNA-SF测得的营养正常者所占比例为80.48%,营养不良者占19.52%。二者均与BMI、MAC、CC、WC、HC、TSF、SSF、ALB等传统营养评价指标呈正相关(r=0.001~0.530, P均<0.05),MNA和MNA-SF得分的Pearson相关系数为0.823(P<0.05),MNA和MNA-SF评价营养状况等级的Spearman相关系数为0.681(P<0.05),MNA和MNA-SF评价营养状况的一致性好(κ=0.681, P<0.001)。以BMI<18.5为评价营养不良的标准,MNA的灵敏度76.2%、特异度93.4%,MNA-SF的灵敏度100%、特异度99.8%。 结论 MNA和MNA-SF均可以用于评价社区老年人的营养状况,MNA-SF比MNA更为简便、有效。

关键词: 微型营养评价法, 营养评价, 营养不良, 微型营养评价精法, 老年人

Abstract: Objective To compare the value of Mini-Nutritional Assessment(MNA)and the Short-Form Mini-Nutritional Assessment(MNA-SF)in evaluating the nutritional status of the elderly in community. Methods A total of 576 elderly ≥60 years in Jinan City were randomly selected. MNA and MNA-SF were used to evaluate the nutritional status of the population. The anthropometric parameters and laboratory indexes were also measured. Results MNA took 10 min to complete while MNA-SF only needed 3 min. MNA showed that the proportion of adequate nutritional status was 79.93%, and that of potential malnutrition was 20.07%, and no malnutrition was found. MNA-SF showed that the proportion of adequate nutritional status was 80.48% and that of malnutrition was 19.52%. Both of them were positively correlated with BMI, MAC, CC, WC, HC, TSF, SSF, ALB and other traditional nutritional evaluation indicators(r=0.001-0.530, P<0.05). The Pearson correlation coefficient between MNA and MNA-SF scores was 0.823(P< 山 东 大 学 学 报 (医 学 版)55卷11期 -张欢欢,等.利用微型营养评价法和微型营养评价精法评价社区老年人的营养状况 \=-0.05). The Spearman correlation coefficient between MNA and MNA-SF was 0.681(P<0.05). MNA and MNA-SF had good consistency in evaluating nutritional status(κ=0.681, P<0.001). With BMI<18.5 as the evaluation criteria of malnutrition, the sensitivity and specificity of MNA were 76.2% and 93.4% respectively, and the sensitivity and specificity of MNA-SF were 93.4% and 100% respectively. Conclusion Both MNA and MNA-SF can be used to evaluate the nutritional status of elderly from community, and MNA-SF is more simple, rapid and effective.

Key words: Short-Form Mini-Nutritional Assessment, Nutrition assessment, Mini-Nutritional Assessment, Elderly, Malnutrition

中图分类号: 

  • R153.3
[1] 中华人民共和国国家统计局. 2010年第六次全国人口普查主要数据公报(第1号)[J]. 中国计划生育学杂志, 2011, 54(8): 511-512.
[2] Kaiser MJ, Bauer JM, Ramsch C, et al. Frequency of malnutrition in older adults: a multinational perspective using the mini nutritional assessment[J]. J Am Geriatr Soc, 2010, 58(9): 1734-1738.
[3] 陈敏敏, 郑松柏. 老年患者的营养与临床结局[J]. 老年医学与保健, 2012, 18(6): 390-394.
[4] Bauer JM, Kaiser MJ, Anthony P, et al. The Mini Nutritional Assessment-its history, todays practice, and future perspectives[J]. Nutr Clin Pract, 2008, 23(4): 388-396.
[5] Kondrup J, Allison SP, Elia M, et al. ESPEN guidelines for nutrition screening 2002[J]. Clin Nutr, 2003, 22(4): 415-421.
[6] Guigoz Y, Vellas B, Garry PJ. Assessing the nutritional status of the elderly: The Mini Nutritional Assessment as part of the geriatric evaluation[J]. Nutr Rev, 1996, 54(1 Pt 2): S59-S65.
[7] Vellas B, Villars H, Abellan G, et al. Overview of the MNA-Its history and challenges[J]. J Nutr Health Aging, 2006, 10(6): 456-465.
[8] Rubenstein LZ, Harker JO, Salva A, et al. Screening for undernutrition in geriatric practice: developing the short-form mini-nutritional assessment(MNA-SF)[J]. J Gerontol A Biol Sci Med Sci, 2001, 56(6): M366-372.
[9] Cederholm T, Bosaeus I, Barazzoni R, et al. Diagnostic criteria for malnutrition-An ESPEN Consensus Statement[J]. Clin Nutr, 2015, 34(3): 335-340.
[10] Joussain P, Ferdenzi C, Djordjevic J, et al. Relationship between psychophysiological responses to aversive odors and nutritional status during normal aging[J]. Chem Senses, 2017, 42(6): 465-472.
[11] Lorenzo-López L, Maseda A, de Labra C, et al, Nutritional determinants of frailty in older adults: A systematic review[J]. BMC Geriatr, 2017,17(1):108. doi: 10.1186/s12877-017-0496-2.
[12] 何芳,王蕾蕾,孟雪杉,等. 肿瘤患者营养状况及对临床结局的影响[J]. 肿瘤代谢与营养电子杂志, 2016, 3(3): 166-169. HE Fang, WANG Leilei, MENG Xueshan, et al. Nutritional status of patients with tumor and its effect on clinical outcomes[J]. Electron J Metab Nutr Cancer, 2016, 3(3): 166-169.
[13] Maasberg S, Knappe-Drzikova B, Vonderbeck D, et al. Malnutrition predicts clinical outcome in patients with neuroendocrine neoplasia[J]. Neuroendocrinology, 2017, 104(1): 11-25.
[14] Slee A, Birch D, Stokoe D. The relationship between malnutrition risk and clinical outcomes in a cohort of frail older hospital patients[J]. Clin Nutr ESPEN, 2016, 15(5): 57-62.
[15] Söderström L, Rosenblad A, Thors Adolfsson E, et al. Malnutrition is associated with increased mortality in older adults regardless of the cause of death[J]. Br J Nutr, 2017, 117(4): 532-540.
[16] 秦海娇, 福琴, 金仙. 微型营养评价法的研究及应用现状[J]. 护理学杂志, 2012, 27(14): 91-94.
[17] 韩燕红, 李斯俭, 袁杰, 等. 微型营养评定法调查城区老年人营养状况及相关因素[J]. 解放军护理杂志, 2008, 25(1): 1-3. HAN Yanhong, LI Sijian, YUAN Jie, et al. Investigation of nutritional status of elders in urban areas and its related factors by mini nrtritional assessment[J]. Nurs J of Chin PLA, 2008, 25(1): 1-3.
[18] 李缨, 陈彪, 关绍晨, 等. 北京社区老年人营养状况及相关因素[J]. 中国老年学杂志, 2012, 32(20): 4479-4481.
[19] 何扬利, 蹇在金, 欧阳敏, 等. MNA和MNA-SF评价老年人营养状况比较[J]. 实用老年医学, 2004, 18(5): 243-245. HE Yangli, JIAN Zaijin, OUYANG Min, et al. Comparison between MNA and MNA-SF in evaluation of nutritional status of the elderly[J]. Pract Geriatr, 2004, 18(5): 243-245.
[20] 吴萍, 王东林, 卞大荣, 等. 应用微型营养评价法及微型营养评价精法评价恶性肿瘤患者的营养状况[J]. 上海医学, 2009, 32(12): 1110-1112. WU Ping, WANG Donglin, BIAN Darong, et al. Mini-nutritional assessment and short-form mini-nutritional assessment in evaluating nutritional status of patients with malignant tumor[J]. Shanghai Med J, 2009, 32(12): 1110-1112.
[21] 廖丽萍, 赵艳, 王玲, 等. 修订版MNA-SF与传统MNA在老年住院患者营养状况评估中与传统营养指标相关性分析[J]. 中国继续医学教育, 2016, 8(35): 181-183. LIAO Liping, ZHAO Yan, WANG Ling, et al. Revised MNA-SF and traditional MNA in elderly inpatients assessment of nutritional status and traditional correlation analysis[J]. China Continuing Medical Education, 2016, 8(35): 181-183.
[22] 孔建华, 张洁, 崔云婧, 等. 两种营养评价方法在老年糖尿病肾病患者中的应用及比较[J]. 临床荟萃, 2017, 32(4): 301-304. KONG Jianhua, ZHANG Jie, CUI Yunjing, et al. Comparison of two methods of nutritional assessment in elderly with diabetic nephropathy[J]. Clinical Focus, 2017, 32(4): 301-304.
[23] 毕研霞, 洪忠新, 张立红, 等. 两种营养筛查方法在神经内科老年住院患者中的应用[J]. 中国食物与营养, 2017, 23(3): 76-80. BI Yanxia, HONG Zhongxin, ZHANG Lihong, et al. Application of two kinds of nutritional screening methods in elderly patients with neurology[J]. Food and Nutrition in China, 2017, 23(3): 76-80.
[24] 刘海燕, 李虹, 唐海英, 等. 80岁以上住院患者营养风险筛查与评估[J]. 实用老年医学, 2016, 39(12): 1014-1016, 1019. LIU Haiyan, LI Hong, TANG Haiying, et al. Nutritional risk screening and assessment in elderly patients aged over 80 years[J]. Pract Ceriatr, 2016, 39(12): 1014-1016, 1019.
[25] 何扬利, 蹇在金. 简易营养评价法及简易营养评价精法对老年人营养不良的评价[J]. 中华老年医学杂志, 2005, 24(4): 278-281. HE Yangli, JIAN Zaijin. The application and evaluation of the elderly malnutrition assessment methods[J]. Chin J Ceriatr, 2005, 24(4): 278-281.
[26] 任姗姗, 王璐, 董萍, 等. 高龄住院患者营养状况分析及评价指标筛选[J]. 中华老年医学杂志, 2014, 33(12): 1341-1344. REN Shanshan, WANG Lu, DONG Ping, et al. Analysis of nutritional status and nutrition assessment index in advanced elderly inpatients[J]. Chin J Ceriatr, 2014, 33(12): 1341-1344.
[27] 侯煜, 徐若男, 杨艳, 等. 微型营养评价法用于80岁以上高龄患者营养评估[J]. 中国临床保健杂志, 2015, 18(2): 150-152. HOU Yu, XU Ruonan, YANG Yan, et al. Mini nutritional assessment used to nutritional assessment in elderly patients over 80 years old[J]. Chin J Clin Healthc, 2015, 18(2): 150-152.
[1] 宋立,张艳,刘洋,王丹. 随访2年观察1例新发突变的营养不良型大疱性表皮松解症[J]. 山东大学学报 (医学版), 2020, 1(8): 120-122.
[2] 潘芳. 基于不同理论模式的老年人心理健康评估的研究进展[J]. 山东大学学报(医学版), 2017, 55(9): 1-5.
[3] 李长瑾,洪炜,赵佳,甘伟. 老年人生活质量与心理弹性的关系及领悟社会支持的中介作用[J]. 山东大学学报(医学版), 2017, 55(9): 6-10.
[4] 江虹,徐晶晶,王瑞,周雅茹,伊向仁, 潘芳. 城市老年人的孤独感与社会支持的增龄性变化及影响因素[J]. 山东大学学报(医学版), 2017, 55(9): 17-22.
[5] 江虹,徐晶晶,王瑞,伊向仁,周雅茹,潘芳. 不同年龄阶段老年人的幸福感、心理压力与心理弹性研究[J]. 山东大学学报(医学版), 2017, 55(9): 11-16.
[6] 王美建,侯新国,梁凯,陈丽. 山东省城市中老年人群血脂现状调查[J]. 山东大学学报(医学版), 2017, 55(5): 70-75.
[7] 李燕,刘坤,孙晓杰. 山东省3县农村老年人与收入相关的健康不平等状况及影响因素[J]. 山东大学学报(医学版), 2016, 54(6): 91-96.
[8] 杨圣思, 程玉峰. 小野寺指数在老年食管癌放射治疗中的临床应用[J]. 山东大学学报(医学版), 2015, 53(6): 54-57.
[9] 张扬, 李万湖, 宋惟阳, 刘春蕾, 张权. 健康中老年人脑血管反应能力分布特征的屏气功能磁共振成像研究[J]. 山东大学学报(医学版), 2015, 53(5): 85-88.
[10] 余慧慧, 雷震, 路翠艳, 江虹, 王淑康, 潘芳. 团体心理干预对糖尿病患者心理和生理状况的影响[J]. 山东大学学报(医学版), 2015, 53(5): 89-94.
[11] 刘坤, 张楠, 李燕, 孙晓杰. 农村老年人资源生成器量表的修订与评价[J]. 山东大学学报(医学版), 2015, 53(2): 87-91.
[12] 杨红. 86例患者外阴营养不良的相关因素调查[J]. 山东大学学报(医学版), 2014, 52(S2): 92-93.
[13] 雷震,江虹,尹世平,丁娟,潘芳. 积极心理干预对社区老年人心理健康与幸福感水平的影响[J]. 山东大学学报(医学版), 2014, 52(2): 93-96.
[14] 李明1,杨华2,高倩倩1,李士雪1. 济南市失能老年人居家长期照护者负担及其影响因素分析[J]. 山东大学学报(医学版), 2013, 51(9): 109-112.
[15] 党宁宁1,2,逄曙光3,初晶学2,Dedee Murrell4,李春阳1. COL7A1基因在营养不良性大疱性表皮松解症的突变研究[J]. 山东大学学报(医学版), 2011, 49(8): 84-89.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!