Assessing Malnutrition in Pregnant Women Using the Dietary Diversity Score and the Mid-Upper Arm Circumference: A Cross-Sectional Study, Zambia

The dietary diversity score (DDS) and the mid-upper arm circumference (MUAC) can be used to assess nutritional status. The DDS is a qualitative measure of food consumption reflecting an individual’s access to different food items and therefore a proxy indicator of the nutritional status. The aim of the study was to assess whether the dietary diversity score and MUAC can be used to assess the nutritional status of pregnant women attending antenatal. A cross-sectional survey was conducted at Chilenje level I Hospital in a township located in Lusaka city, Lusaka province. The study employed quantitative methods to collect and analyse data on the dietary patterns of individuals in the previous 24 hours before the survey. Health facilities were randomly selected and systematic sampling was used to select a sample of 299 pregnant women. An interview schedule was used to collect data. Median and interquartile range were used to compare demographic data. Spearman’s Correlation for two continuous variables was used to establish associations between DDS and the MUAC. The median age was 27 years. About 44% of the women were in the lowest dietary diversity category, indicating inadequate nutrient intake, 31% in the medium category and 24% in the high intake. Dietary diversity score was negatively correlated with mid-upper arm circumference (p = 0.1295). However, most of the women in the lower dietary diversity score category (75%) had a high mid-upper arm circumference meaning that their nutritional status was good. Dietary diversity score can be used to predict malnutrition in pregnant women. The mid-upper arm circumference was negatively correlated with the 24hour dietary diversity score implying that we might not rely on this measurement to assess the nutritional status.

基于上臂围和小腿围预测结直肠癌肌肉减少症的初步探索

目的探讨上臂围(MAC)和小腿围(CC)对结直肠癌(CRC)患者肌肉减少症的预测价值。方法本研究为横断面研究,纳入2022年4月至2023年8月于西南医科大学附属医院胃肠外科首次诊断为CRC的372例患者,通过生物电阻抗法(BIA)测定四肢骨骼肌质量(ASM)和四肢骨骼肌质量指数(ASMI),测定MAC、CC、握力和6米步速等,按肌肉减少症分组比较肌肉减少症患者与非肌肉减少症患者基线情况差异。按照性别分组主要参考既往相似文献,男女性MAC和CC的大小差异大,所以本研究按照性别分层分析得出不同性别的截止点,采用ROC曲线比较MAC和CC对CRC患者肌肉减少症的预测价值并确定最佳截止点,计算Kappa值判断MAC、CC与肌肉减少症诊断标准的一致性。结果372例CRC患者中,男性233例(62.6%),女性139例(37.4%),肌肉减少症81例(21.8%)。ROC曲线示,MAC预测肌肉减少症的最佳截止点为男性24.9cm(敏感度81.8%,特异度73.0%),女性23.7 cm(敏感度80.8%,特异度72.6%);CC预测肌肉减少症的最佳截止点为男性32.4 cm(敏感度74.5%,特异度80.9%),女性31.0 cm(敏感度88.5%,特异度66.4%)。男性患者的MAC、CC及两者联合预测肌肉减少症的AUC值分别为0.824、0.851、0.864,女性患者分别为0.819、0.801、0.828,联合预测的价值更高。与肌肉减少症诊断标准进行一致性比较,男性MAC和CC的Kappa值分别为0.443、0.493,女性MAC和CC的Kappa值分别为0.385、0.334。结论CRC患者MAC、CC对肌肉减少症均具有较好的预测价值,且两者联合的预测效果更好。