相位角评估喉癌病人营养状况可行性研究

目的:探讨相位角(PA)评估喉恶性肿瘤病人营养状况的可行性.方法:收集140例喉癌住院病人,术前使用Inbody S 10行人体成分分析、记录PA值,同时进行营养筛查与评估、体格测量与实验室检查.分析PA与营养相关指标的相关性,并以病人主观整体评估(PG-SGA)为营养评价标准,绘制PA的受试者工作特征(ROC)曲线,进而根据截断值分为低PA组与高PA组,计算低PA组营养不良的相对危险度.结果:PA与体质量、BMI、上臂围、上臂肌围、总蛋白、前白蛋白、血红蛋白呈正相关(P＜0.05),与年龄、细胞外水分率(ECW/TBW)呈负相关(P＜0.05);PA的ROC曲线下面积0.71(P＜ 0.01),诊断为营养不良的PA截断值为5.89,灵敏度0.69,特异度0.68,约登指数0.37;低PA组营养不良的比例(71.2％)明显高于高PA组(34.3％),与高PA组相比,低PA组发生营养不良的相对危险度为2.28(95％CI,1.53 ～ 3.41).结论:相位角与喉癌病人的营养状况密切相关,在喉癌病人营养不良的诊断中具有一定的临床应用价值.     

相位角评估喉癌病人营养状况可行性研究

目的:探讨相位角(PA)评估喉恶性肿瘤病人营养状况的可行性.方法:收集140例喉癌住院病人,术前使用Inbody S 10行人体成分分析、记录PA值,同时进行营养筛查与评估、体格测量与实验室检查.分析PA与营养相关指标的相关性,并以病人主观整体评估(PG-SGA)为营养评价标准,绘制PA的受试者工作特征(ROC)曲线,进而根据截断值分为低PA组与高PA组,计算低PA组营养不良的相对危险度.结果:PA与体质量、BMI、上臂围、上臂肌围、总蛋白、前白蛋白、血红蛋白呈正相关(P＜0.05),与年龄、细胞外水分率(ECW/TBW)呈负相关(P＜0.05);PA的ROC曲线下面积0.71(P＜ 0.01),诊断为营养不良的PA截断值为5.89,灵敏度0.69,特异度0.68,约登指数0.37;低PA组营养不良的比例(71.2％)明显高于高PA组(34.3％),与高PA组相比,低PA组发生营养不良的相对危险度为2.28(95％CI,1.53 ～ 3.41).结论:相位角与喉癌病人的营养状况密切相关,在喉癌病人营养不良的诊断中具有一定的临床应用价值.     

维持性血液透析患者营养状况分析

目的 评价维持性血液透析患者的营养状况,为制定个性化的营养治疗方案提供依据.方法 对68例维持性血液透析患者采用膳食问卷调查、主观综合性营养评估、人体测量和实验室检查等方法对患者进行营养状态评价. 结果SGA评价：营养状况正常43例（占63.23%） 中度营养不良19例（占27.94%） 重度营养不良6例（占8.82%）.营养正常组与中度营养不良组相比较,体质量、每日能量摄入、上臂围、上臂肌围、白蛋白（ALB）、前白蛋白差异有统计学意义 营养正常组与重度营养不良组比较,除上述差异外,年龄、透析龄、每日标准体质量蛋白质摄入、血红蛋白、甘油三酯水平差异有统计学意义.结论 血液透析患者营养不良的发生率较高,与年龄、透析龄、每日标准体质量蛋白质和能量摄入有关,应对血透患者进行合理的营养治疗.     

1200例住院病人营养状况调查和分析

目的:调查部分科室住院病人人院时的营养状况,为存在营养不良及营养不良风险的病人及时接受营养支持治疗提供参考依据.方法:按入院时间顺序,对消化科、神经内科、肾脏科、呼吸科、心胸外科和普通外科各选择200例病人,采用欧洲营养不良风险排查表(NRS)进行营养不良风险和全面营养状况评估,统计总体营养不良及存在营养不良风险发生率.结果:不同专科病人入院时营养不良的发生率为7.5%～59%.而存在营养不良的风险为36%～72%.结论:住院病人因疾病及其严重程度不同,营养不良的发生率和特点亦不同,NRS可评估住院病人的营养不良和营养不良风险.     

胰腺癌患者术前营养状况分析

目的：了解胰腺癌患术前的营养状况。方法：对21例胰腺癌患术前进行人体测量、实验室检查、膳食调查和营养评价。结果：营养评价结果显示，有相当比例患存在不同程度营养不良，摄入的总热量和各营养素亦存在着明显不足和不合理现象。结论：术前应及时了解患的营养状况；根据膳食调查结果合理调整患饮食。     

用不同评价方法调查分析普外科患者术前营养状况

目的了解普外科择期手术患者术前的营养状况，比较不同营养评价方法间的差异。方法采用人体测量法、实验室检查以及问卷量表法评定北京大学第三医院普外科择期手术患者术前的营养状况，分析各营养评价方法的关系。结果共238例患者入选，不同营养评价方法得出患者营养不良发生率不同（5．0％-48．3％），由大到小依次是上臂肌围48．3％，三头肌皮褶厚度32．4％，总淋巴细胞计数20．7％，主观全面评定法（SGA）14．7％，血红蛋白11．4％，体重10．5％，营养评价简易问卷法（SNAQ）9．7％，简易营养评定法（MNA）8．4％，Nottingham筛查量表8．0％，体质指数7．1％，白蛋白5．0％。各种营养状况评价方法之间具有相关性。结论可采用综合营养评价方法进行普外科患者术前营养评估，或先采用简单、快速的评定方法进行初步营养筛查，之后结合人体测量或实验室检查法进行进一步诊断。     

西藏地区3岁以下儿童营养状况分析

目的 了解西藏地区3岁以下儿童的营养状况。方法 采用横断面调查设计与分层多阶段随机抽样法，获取样本，以身长和体重作为衡量儿童营养状况的基本指标，利用WHO／NCSH参考标准对儿童的营养状况进行评价。结果 调查获得1655对母与子，与WHO／NCHS标准分布比较，该地区3岁以下儿童整体营养状况较差，以身长减低为突出，提示为长期的慢性营养不良。生长迟缓、低体重和消瘦的总患病率分别为：39．0％，23．7％，5．6％，农村高于城市，牧区高于农区。海拔是影响该地区儿童体格发育的重要因素，对身长的影响尤为明显。结论 西藏地区3岁以下儿童的整体营养状况差，中重度营养不良的患病率高，地区间差异较大。     

仪陇县中小学生现时营养状况分析

[目的]了解仪陇县中小学生的现时营养状况。[方法]2001年上半年，选择仪陇县部分中小学生，测量身高、体重，采用营养评价参考标准(身高标准体重)进行营养评价。[结果]26928名学生，营养不良、超重、肥胖检出率分别为18.76％、6．56％、1．64％。营养不良检出率，女生高于男生，城郊学校学生＞城区学校学生＞乡镇学校学生。[结论]仪陇县中小学生的营养状况不容乐观。应大力提倡平衡膳食、合理营养，推行“学生饮用能计划”，增进学生体质健康。     

消化系统恶性肿瘤住院病人营养状况与生活质量的相关性分析

目的:探讨消化系统恶性肿瘤住院病人营养状况与生活质量的相关性.方法:采用NRS 2002营养风险筛查量表、PG-SGA营养评估量表对昆明医科大学第一附属医院自2018年1月至2019年12月病理确诊为消化系统恶性肿瘤者行营养诊断,采用欧洲癌症研究与治疗组织生存质量问卷(第3版)调查生活质量,分析营养状况与生活质量的相关...     

34例癌症病人的营养状况分析

对３４例癌症病人进行了营养调查分析。结果表明，平均每人每日摄入的热能为ＲＤＡ的６９％，蛋白质为ＲＤＡ的８８．３％，其它营养素也明显低于供给标准。主要为病人摄入食量少。体格检查（体重、上臂肌围等）结果，一半以上病例有不同程度的营养不良。生化检验结果提示，６４．７％的病例血红蛋白水平低于正常，３５．５％的病例血清蛋白低于正常，８２．４％的病例血液淋巴细胞计数低于正常，免疫力低下。结果提示，癌症病人的营养问题应该引起足够的重视并得到加强。     

Association of Drug Application and Hydration Status in Elderly Patients

Due to multifactorial reasons, such as decreased thirst and decreased total body water, elderly patients are vulnerable to dehydration. Mild cognitive impairment (MCI) or dementia increase the risk of dehydration and, in turn, dehydration decreases cognitive performance. The study aims to identify and assess differences in hydration status, taking into account patients’ drug treatment and diseases, using bioelectrical impedance vector analysis (BIVA), thereby revealing unfavorable aspects of prognosis. 447 geriatric patients (241 women, 206 men) including information on medication and bioelectrical impedance analysis (BIA) were investigated, which allowed studying the association between 40 drugs and the hydration status. First, patients were divided into disease groups. Renal disease and diuretic treatment were significantly different in both sexes, whereas cardiovascular patients differed exclusively for females. Next, drug enrichment was examined in either hyperhydrated or dehydrated patients. Simvastatin, candesartan, bisoprolol, amlodipine, olmesartan, furosemide, torasemide, allopurinol, mirtazapine, pantoprazole, cholecalciferol, and resveratrol showed enrichment depending on hydration status. This study demonstrated that patients can be differentiated and stratified by BIVA, taking into account medication and disease associated with hydration status. Although patients diagnosed with MCI and therefore treated with resveratrol, BIVA still showed evaluated dehydration. This is unfavorable in terms of prognosis and requires special attention.     

Nutritional Status Of Cancer Patients

Good nutritional status is related to improved survival and freedom from relapse among children with malignancies.     

Evaluation of Nutritional Status and Methods to Identify Nutritional Risk in Rheumatoid Arthritis and Spondyloarthritis

Patients with rheumatoid arthritis (RA) and spondyloarthritis (SpA) experience several nutritional challenges and are prone to develop malnutrition. This observational study aimed to perform a comprehensive nutritional assessment of outpatients diagnosed with RA and SpA, as well as to evaluate methods to identify nutritional risk. Nutritional status was investigated by anthropometric measures, body composition (DXA, dual energy X-ray absorptiometry), and handgrip strength (HGS). Nutritional risk was classified by Nutritional Risk Screening 2002 (NRS2002) and malnutrition was defined by the Global Leadership Initiative on Malnutrition (GLIM) criteria and fat-free mass index (FFMI; kg/m², <16.7 (M), <14.6 (F)). Out of 71 included patients, 46 (66%) were abdominally obese, 28 (39%) were obese in terms of body mass index (BMI), and 33 (52%) were obese in terms of the fat mass index (FMI; kg/m², ≥8.3 (M), ≥11.8 (F)). Malnutrition was identified according to FFMI in 12 (19%) patients, according to GLIM criteria in 5 (8%) patients, and on the basis of BMI (<18.5 kg/m²) in 1 (1%) patient. None were identified by NRS2002 to be at nutritional risk. Our study revealed high prevalence of abdominal obesity and low FFMI. Waist circumference was a good indicator of FMI. BMI, NRS2002, and HGS did not capture patients with malnutrition identified by DXA.     

Patients With Mitochondrial Disease Have an Inadequate Nutritional Intake

Background: Mitochondrial disease (MD) is a group of disorders caused by dysfunctional mitochondria, the organelles that generate energy for the cell. Malnutrition in patients with MD may lead to increased mitochondrial dysfunction, which may enhance already existing symptoms. The aim of this study was to investigate whether patients with MD have an insufficient or unbalanced food intake and to establish which nutrients and product groups are particularly compromised in this patient group. Methods: In this observational, cross‐sectional, retrospective study, sixty 3‐day nutrition diaries of adult patients with MD were analyzed and compared with the Dutch recommended daily allowance and the Dutch National Food Consumption Survey (DNFCS). Results: The intake of all macronutrients and micronutrients of patients with MD was significantly different from Dutch recommended daily allowance values with the exception of fat and iron. In particular, protein and calcium intake in patients with MD was significantly lower when compared with the DNFCS. Interindividual differences were high. Also, intake of fiber, sugars, saturated fat, and vitamin D differed from recommendations for the overall population. In comparison with DNFCS, the intake of dairy products and drinks was significant lower in patients. Conclusions: Our study demonstrates that many patients with MD have an inadequate diet. Specifically, intake of protein, calcium, dairy products, and fluids were low. Overall, eating a healthy diet seems as difficult for patients with MD as for the general population. Since interindividual differences are high, individual diet counseling is recommended for all adult patients with MD.     

Dietary Structure and Nutritional Status of Chinese Beekeepers: Demographic Health Survey

BackgroundBeekeeping and honey gathering are traditional forms of agricultural farming in China. However, only few studies have focused on the nutritional status and health level of this special occupational group.ObjectiveBy comparing the health status of apiculturists (beekeepers) and vegetable farmers in plain areas of Hubei Province, and analyzing the influence of dietary structure and intake on their nutritional level, this paper provides a scientific theoretical basis for the further development of health education and disease prevention for beekeepers.MethodsFrom February to April 2016, 191/236 beekeepers (80.9% of the total beekeepers) with large-scale breeding (300-500 colonies) and 182 vegetable farmers in the same area were sampled by the cluster sampling method. Their nutrient composition was analyzed using a human body composition analyzer, dietary structure information was collected using the dietary frequency query method, and cognitive function was investigated. In addition, blood samples of both groups were collected.ResultsA total of 362 valid questionnaires (beekeepers/vegetable farmers: 185/177) were collected, with an effective response rate of 97.1% (362/373). Both beekeepers and vegetable farmers were overweight, and the beekeepers’ grip strength was much stronger than that of the vegetable farmers’ regardless of gender. The dietary structure of beekeepers is very unique: 29.7% (55/185) of beekeepers indicated consuming royal jelly regularly for more than 10 years. Their main foods are grain, cereals, and fresh vegetables; 68.1% (126/185) of the beekeepers never drank milk and other dairy products, and their overall nutrient intake is unbalanced. The average intake of cellulose in this group was also significantly higher than that in the epidemiological survey in the same sex and age group. The intake of vitamin A and selenium in the beekeepers group was significantly higher than that in the vegetable-farmers group (all P<.001). The blood indices of creatinine (P=.03) and blood copper (P<.001) in the beekeepers group were significantly higher than those in the vegetable-farmers group, and the total protein, albumin, calcium, sodium, potassium, phosphorus, folic acid, and vitamin B12 in the beekeepers group were significantly lower than those in the vegetable-farmers group (P<.03 for potassium and P<.001 for others). The total Mini-Mental State Examination (MMSE) score of the beekeepers group was 28.1, significantly higher (P=.006) than that of the vegetable-farmers group (23.3).ConclusionsThe beekeepers in this area have their special dietary structure, body nutrient level, and disease characteristics. The cognitive level of the beekeepers who regularly consume royal jelly is significantly higher than that of their peers. The chronic diseases of this special occupational group are closely related to their lifestyle and nutritional status, so more attention and in-depth studies are needed to improve the quality of life of this population.     

大学生营养状况调查

目的 了解学生营养状况,建立学校营养保健机制.方法 采用身高标准体重法和Broca改良公式,对玉林师范学院2000年与2005年的学生进行营养状况评价.结果 营养不良1 102人,占46.91 %;超重、肥胖84人,占3.58 %;男生营养不良392人,占16.69 %,女生营养不良710人,占30.23 %,男女营养不良率差异具有统计学意义(χ2＝31.31,p＜0.01).结论 学生营养不良与超重肥胖并存,营养不良率较高,但营养不良程度较轻.营养不良率女生高于男生,超重和肥胖男生高于女生.应尽快对学生加强营养知识教育,推广营养早餐,合理调配膳食,提高大学生营养健康水平.     

应用主观全面评定法评价维持性血液透析患者营养状况

目的应用主观全面评定法（SGA）对维持性血液透析患者（MHD）的营养状态进行评价。方法对116例MHD患者应用SGA方法进行营养评估，测定肱三头肌皮褶厚度、上臂围、上臂肌围（MAMC）等人体测量学指标和血清白蛋白（ALB）、C反应蛋白（CRP）等实验室指标，并进行相关性分析。结果SGA法的评定结果与年龄、透析时间、肱三头肌皮褶厚度、上臂围、MAMC、体质指数（BMI）、ALB、CRP均有显著相关性（P〈0．01）；与总蛋白、血清肌酐无相关性（P〉0．05）。多因素分析显示，在调节年龄、BMI后，SGA评分与CRP、ALB、MAMC仍存在显著相关性（相关系数分别为0．2816、0．3368、0．6143，P〈0．05）。结论SGA法在我国MHD患者的营养评价中适用，是一种经济、有效的营养评定方法。     

大学生营养状况调查

目的了解学生营养状况,建立学校营养保健机制。方法采用身高标准体重法和Broca改良公式,对玉林师范学院2000年与2005年的学生进行营养状况评价。结果营养不良1102人,占46.91%;超重、肥胖84人,占3.58%;男生营养不良392人,占16.69%,女生营养不良710人,占30.23%,男女营养不良率差异具有统计学意义(χ2=31.31,p<0.01)。结论学生营养不良与超重肥胖并存,营养不良率较高,但营养不良程度较轻。营养不良率女生高于男生,超重和肥胖男生高于女生。应尽快对学生加强营养知识教育,推广营养早餐,合理调配膳食,提高大学生营养健康水平。     

Assessment of Nutritional Status and Nutrition Impact Symptoms in Patients Undergoing Resection for Upper Gastrointestinal Cancer: Results from the Multi-Centre NOURISH Point Prevalence Study

Background: Identification and treatment of malnutrition are essential in upper gastrointestinal (UGI) cancer. However, there is limited understanding of the nutritional status of UGI cancer patients at the time of curative surgery. This prospective point prevalence study involving 27 Australian tertiary hospitals investigated nutritional status at the time of curative UGI cancer resection, as well as presence of preoperative nutrition impact symptoms, and associations with length of stay (LOS) and surgical complications. Methods: Subjective global assessment, hand grip strength (HGS) and weight were performed within 7 days of admission. Data on preoperative weight changes, nutrition impact symptoms, and dietary intake were collected using a purpose-built data collection tool. Surgical LOS and complications were also recorded. Multivariate regression models were developed for nutritional status, unintentional weight loss, LOS and complications. Results: This study included 200 patients undergoing oesophageal, gastric and pancreatic surgery. Malnutrition prevalence was 42% (95% confidence interval (CI) 35%, 49%), 49% lost ≥5% weight in 6 months, and 47% of those who completed HGS assessment had low muscle strength with no differences between surgical procedures (p = 0.864, p = 0.943, p = 0.075, respectively). The overall prevalence of reporting at least one preoperative nutrition impact symptom was 55%, with poor appetite (37%) and early satiety (23%) the most frequently reported. Age (odds ratio (OR) 4.1, 95% CI 1.5, 11.5, p = 0.008), unintentional weight loss of ≥5% in 6 months (OR 28.7, 95% CI 10.5, 78.6, p < 0.001), vomiting (OR 17.1, 95% CI 1.4, 207.8, 0.025), reduced food intake lasting 2–4 weeks (OR 7.4, 95% CI 1.3, 43.5, p = 0.026) and ≥1 month (OR 7.7, 95% CI 2.7, 22.0, p < 0.001) were independently associated with preoperative malnutrition. Factors independently associated with unintentional weight loss were poor appetite (OR 3.7, 95% CI 1.6, 8.4, p = 0.002) and degree of solid food reduction of <75% (OR 3.3, 95% CI 1.2, 9.2, p = 0.02) and <50% (OR 4.9, 95% CI 1.5, 15.6, p = 0.008) of usual intake. Malnutrition (regression coefficient 3.6, 95% CI 0.1, 7.2, p = 0.048) and unintentional weight loss (regression coefficient 4.1, 95% CI 0.5, 7.6, p = 0.026) were independently associated with LOS, but no associations were found for complications. Conclusions: Despite increasing recognition of the importance of preoperative nutritional intervention, a high proportion of patients present with malnutrition or clinically significant weight loss, which are associated with increased LOS. Factors associated with malnutrition and weight loss should be incorporated into routine preoperative screening. Further investigation is required of current practice for dietetics interventions received prior to UGI surgery and if this mitigates the impact on clinical outcomes.