简易营养评价法在评价老年糖尿病患者营养状况中的应用

目的探讨简易营养评价法（MNA）在评价老年糖尿病患者营养状况时的敏感性和特异性。方法对116例住院老年糖尿病患者进行MNA问卷调查、人体测量、生化检测和24小时膳食回顾调查。分析MNA用于评价老年糖尿病患者营养状况的敏感性和特异性。结果MNA问卷调查显示住院老年糖尿病患者28．4％营养不良，32．8％具有营养不良危险，38．8％营养良好。当以MNA〈17为界点时，MNA的敏感性分别为75．0％、64．7％和65．8％，特异性分别为76．9％、77．8％和79．5％；当以MNA≤23．5为界点时，MNA的敏感性分别增加为100％、100％和97．4％，特异性下降至43．2％、45．5％和50．0％。MNA与体质指数（r=0．474，P〈0．01）、三头肌皮褶厚度（r=0．369，P〈0．01）、上臂肌围（r=0．479，P〈0．01）、血清白蛋白（r=0．613，P〈0．01）、血红蛋白（r=0．335，P〈0．01）和总淋巴细胞计数（r=0．433，P〈0．01）均呈显著正相关。结论老年糖尿病患者营养不良的发生率高。MNA是一种用于老年糖尿病患者营养状况评价的可靠、灵敏方法。

Application of Mini Nutritional Assessment in Evaluating Nutrition Status of Elderly Patients with Diabetes Mellitus

Objective To investigate the sensitivity and specificity of the Mini Nutritional Assessment （MNA） in evaluating the nutrition status of elderly patients with diabetes mellitus. Methods The nutrition status of 116 hospitalized elderly patients with diabetes mellitus were investigated with MNA questionnaire, anthropometric measurements, biochemical tests, and 24-hour dietary recall. The results were recorded and compared. Resuits The MNA assessment showed that 28.4% of the hospitalized elderly patients were ＂malnourished＂, 32.8% were ＂at risk＂, and 38.8% were ＂well nourished＂. When MNA 〈 17 was used as the frontier point, the sensitivity of MNA was 75.0% , 64.7% , and 65.8% , and the specificity was 76. 9% , 77. 8% , and 79.5%. When MNA≤23.5 was used as the frontier point, the sensitivity increased to 100% , 100% , and 97.4% , while the specificity decreased to 43.2% , 45.5% , and 50. 0%. MNA score was significantly correlated body mass index （ r = 0. ,474, P 〈 0.01 ）, triceps skin fold thickness （ r = 0. 369, P 〈 0.01 ）, arm muscle circumference （ r = 0.479, P 〈 0.01 ） , albumin scores （ r = 0. 613, P 〈 0.01 ）, hemoglobin （ r = 0. 335, P 〈 0. 01 ）, and total lymphocyte count （ r = 0. 433, P 〈 0. 01 ）. Conclusions The elderly patients with diabetes mellitus may be at risk of malnutrition. MNA is a reliable tool to evaluate the nutrition status of the elderly.