医务工作者体成分现况及各指标对营养状况的评估效果

Current status of physical composition in medical workers and the evaluation effects of each indicator on nutritional status

目的:分析医务工作者体成分现况及各指标对营养状况的评估效果。方法:本研究为横断面研究,于2021年5月21日至6月22日招募北京某医院313例医务工作者为研究对象进行体成分测量,采用方差分析比较其体脂肪总量、去脂体重、体脂率、骨骼肌、蛋白质、水分、矿物质、基础代谢率指标的年龄、性别分布差异,分别用蛋白质含量、体脂率和体重指数评价医务工作者的营养状况,并分析其评估效果。结果:纳入分析的313例医务工作者中,女性221例,男性92例;女性体脂肪总量、去脂体重、骨骼肌及基础代谢率均与年龄呈正相关( F=19.823、6.745、6.561、6.707)(均 P<0.001);男性各年龄组体成分指标差异均无统计学意义(均 P>0.05)。女性医务工作者体脂肪总量显著高于男性(17.58 kg比17.08 kg),总水分、蛋白质、矿物质、去脂体重、骨骼肌及基础代谢率均显著低于男性[30.40 kg比41.78 kg、8.07 kg比11.26 kg、2.96 kg比3.88 kg、41.43 kg比56.92 kg、22.37 kg比31.98 kg、1 264.86 kcal(1 kcal=4.184 kJ)比1 599.39 kcal](均 P<0.05)。医务工作者蛋白质含量正常190例(60.7%),蛋白质含量缺乏103例(32.9%),蛋白质含量超标20例(6.3%);体脂率正常110例(35.1%),体脂率超标193例(61.6%),体脂率不足10例(3.2%);体重指数正常198例(63.2%),其中体脂率正常145例(73.2%),体脂率超标53例(26.7%),蛋白质含量正常108例(54.5%),蛋白质含量不足89例(44.9%),蛋白质含量超标1例(0.5%);体重指数超标103例(32.9%),其中体脂率正常20例(19.4%),属于肌肉/骨骼强壮型,蛋白质含量正常83例(80.6%),属于肌肉良好型;体重指数不足12例(3.8%),其中体脂率正常6例(50.0%)。 结论:医务工作者体成分分布存在明显性别差异,女性体脂肪总量、去脂体重、骨骼肌及基础代谢率与年龄相关,仅根据体重指数进行个体营养状况评价会低估肥胖率,蛋白质/肌肉含量低于或高于正常者均不宜用体重指数评价。

Objective To analyze the current status of physical composition in medical workers and the evaluation effects of each indicator on nutritional status.Methods It was a cross-sectional study.A total of 313 medical workers from one hospital in Beijing were recruited from May 21st to June 22nd in 2021 for body composition measurement.Variance analysis was used to compare the age and gender distribution differences in total body fat,fat-free body weight,body fat percentage,skeletal muscle,protein,water,mineral,and basal metabolic rate indicators among the medical workers.Protein content,body fat percentage,and body mass index(BMI)were used to evaluate the nutritional status of medical workers,and the evaluation effects were analyzed too.Results Of the 313 medical workers included in this study,there were 221 females and 92 males.In females,total body fat,fat-free body weight,skeletal muscle mass,and basal metabolic rate were all positively correlated with age(F=19.823,6.745,6.561,6.707)(all P<0.001).There was no significant differences in body composition indicators among male participants of different age groups(all P>0.05).The total body fat in female medical workers was significantly higher than that in males(17.58 kg vs 17.08 kg).Total water,protein,minerals,fat-free body weight,skeletal muscle mass,and basal metabolic rate were all significantly lower in female medical workers when compared with those in males[30.40 kg vs 41.78 kg,8.07 kg vs 11.26 kg,2.96 kg vs 3.88 kg,41.43 kg vs 56.92 kg,22.37 kg vs 31.98 kg,1264.86 kcal(1 kcal=4.184 kJ)vs 1599.39 kcal](all P<0.05).Among the medical workers,190 cases(60.7%)had normal protein levels,103 cases(32.9%)had protein deficiencies,and 20 cases(6.3%)had protein levels exceeding the standard.Additionally,110 cases(35.1%)had normal body fat ratios,193 cases(61.6%)had excessive body fat ratios,and 10 cases(3.2%)had insufficient body fat ratios.Concerning body mass index(BMI),198 cases(63.2%)had normal BMI.Among them,145 cases(73.2%)had normal body fat ratios,53 cases(26.7%)had excessive body fat ratios,108 cases(54.5%)had normal protein levels,89 cases(44.9%)had insufficient protein levels,and 1 case(0.5%)had excessive protein levels.Furthermore,103 cases(32.9%)had excessive BMI,with 20 cases(19.4%)having normal body fat ratios indicating the muscle/bone strength type,and 83 cases(80.6%)having normal protein levels indicating the muscular type.Lastly,12 cases(3.8%)had insufficient BMI,including 6 cases(50.0%)with normal body fat ratios.Conclusion There are significant gender differences in body composition distribution among healthcare workers.In females,total body fat,lean body mass,skeletal muscle,and basal metabolic rate are all correlated with age.Evaluating individual nutrition status based solely on BMI would underestimate the obesity rate.Individuals with low or high protein/muscle content should not be assessed using BMI.