主观整体评估和微型营养评估在老年代谢综合征患者营养状况评估中的运用

Application of mini nutritional assessment and subject global assessment in elderly patients with metabolic syndrome

目的比较新版微型营养评估(mini nutritional assessment,MNA^R)和主观整体评估(subjective global assessment,SGA)在老年代谢综合征患者营养评价中的作用。方法对106例60~97岁诊断为代谢综合征的老年患者进行体格检查和相应生化指标检测,分别采用SGA、MNA^R法对其进行营养状况评价,以血清白蛋白(Alb)作为金标准,对SGA、MNA^R的评估结果进行比较分析。结果根据MNA^R评价结果显示,营养正常的有50例(47.16%),存在营养风险的有38例(35.85%),患有营养不良的有18例(16.98%);SGA评估结果显示:营养正常的有52例(49.06%),存在轻-中度营养不良的有49例(46.23%),存在重度营养不良的有5例(4.71%)。MNA^R的灵敏度为89.5%,特异度为55.2%;SGA的灵敏度为84.2%,特异度为56.3%。MNA^R和SGA的ROC曲线下面积分别为0.749(P=0.001)和0.711(P=0.004)。结论使用MNA^R和SGA评估结果显示老年代谢综合征患者营养不良的发生率较高;SGA和MNA^R均可作为老年代谢综合征患者良好可靠的营养状况评估方法,在老年代谢综合征患者的快速营养筛查方面,MNA^R略优于SGA。

Objective To assess the value of new mini nutritional assessment（ MNA^R） and subjective global assessment（ SGA） in nutritional assessment in elderly patients with metabolic syndrome. Methods 106 patients aged 60 to 97 years with metabolic syndrome were selected. The anthropometric measurement and biochemical detection were performed and the nutrition status was evaluated using SGA and MNA^Rrespectively. Results MNA^Rshowed that there were 50 patients with eutrophy（ 47. 16%）,38 patients with nutritional risk（ 35. 85%）,18 patients with malnutrition（ 16. 98%）. SGA showed that there were 52 patients with eutrophy（ 49. 06%）,49 patients with light-medium malnutrition（ 46. 23%）,5 patients with serious malnutrition（ 4. 71%）. The sensitivity of MNA^Rwas 89. 5% and the specificity was55. 2%; the sensitivity of SGA was 84. 2% and the specificity was 56. 3%. The areas under the ROC curve by MNA^Rand SGA was 0. 749（ P = 0. 001） and 0. 711（ P = 0. 004） respectively. Conclusions The nutritional assessment using MNA^Rand SGA reveals that the incidence rate of malnutrition in the elderly patients with metabolic syndrome is very high.SGA and MNA^Rcan both be used as a reliable nutritional assessment method. In respect of quick nutrition screening for the elderly patients with metabolic syndrome,MNA^Ris slightly better than SGA.