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Birth weight mediates the association of maternal undernutrition with child undernutrition prevalence in West Africa 在西非,出生体重是孕产妇营养不良与儿童营养不良发生率之间关系的中介。
IF 3.6 3区 医学 Q2 NUTRITION & DIETETICS Pub Date : 2024-05-28 DOI: 10.1038/s41430-024-01453-5
A. Kofi Amegah, Roland Ayinemi, Christian Sewor, Haile Mekonnen Fenta, Kelvin Yeboah, Seidu Awal Mohammed, Duah Dwomoh, Samuel K. Annim, Saverio Stranges, Ngianga-Bakwin Kandala
Maternal nutritional status before and during pregnancy is an important determinant of foetal health. In West Africa, maternal and child undernutrition remains a major public health problem and it is important to establish the mechanistic pathway linking the two disorders to help address the problem. We therefore assessed the mediating role of low birth weight (LBW) in the relationship of maternal undernutrition with child undernutrition in West Africa. We included recent (2010–2019) DHS data from thirteen West African countries. Poisson regression model with robust standard errors was used to assess the relationship between maternal undernutrition (body mass index and anaemia) and child undernutrition (stunting, wasting, underweight, and anaemia). Structural equation modelling was used to conduct the mediation analysis. Prevalence of stunting, wasting, underweight, and anaemia among under-five children in West Africa was found to be 32.4%, 8.1%, 20.1%, and 71.5%, respectively. We found children of underweight mothers to be more likely to be undernourished (stunted, wasted, and underweight) and anaemic compared to children of normal-weight mothers. Also, children of anaemic mothers were more likely to be stunted and anaemic but not wasted compared with children of non-anaemic mothers. LBW mediated the observed relationships between maternal BMI and childhood stunting (22.6%), and maternal anaemia and childhood stunting (24.9%), wasting (11.7), and anaemia (6.6%). We found maternal undernutrition to be associated with child undernutrition in West Africa with LBW noted to be a mediator of the observed relationship. We recommend that, to address the child undernutrition problem in West Africa, governments and policymakers must integrate measures to address the burden of LBW.
背景:孕前和孕期的母体营养状况是胎儿健康的重要决定因素。在西非,孕产妇和儿童营养不良仍然是一个重大的公共卫生问题,因此必须建立连接这两种疾病的机制途径,以帮助解决这一问题。因此,我们评估了低出生体重(LBW)在西非孕产妇营养不良与儿童营养不良关系中的中介作用:我们纳入了 13 个西非国家最近(2010-2019 年)的人口与健康调查数据。采用带稳健标准误差的泊松回归模型来评估孕产妇营养不良(体重指数和贫血)与儿童营养不良(发育迟缓、消瘦、体重不足和贫血)之间的关系。结构方程模型用于进行中介分析:结果:西非五岁以下儿童发育迟缓、消瘦、体重不足和贫血的发生率分别为 32.4%、8.1%、20.1% 和 71.5%。我们发现,与母亲体重正常的儿童相比,母亲体重不足的儿童更容易营养不良(发育迟缓、消瘦和体重不足)和贫血。此外,与母亲不贫血的儿童相比,母亲贫血的儿童更有可能发育迟缓、贫血但不消瘦。观察到的母亲体重指数与儿童发育迟缓(22.6%)、母亲贫血与儿童发育迟缓(24.9%)、消瘦(11.7%)和贫血(6.6%)之间的关系中,低体重儿起了中介作用:我们发现,在西非,孕产妇营养不良与儿童营养不良相关,而低体重儿是这种关系的中介。我们建议,为解决西非儿童营养不良问题,政府和政策制定者必须采取综合措施,解决枸杞营养不良问题。
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引用次数: 0
Effects of GLP1 receptor analogues in obesity with neurodevelopmental disorder: case report of a patient with holoprosencephaly GLP1 受体类似物对伴有神经发育障碍的肥胖症的影响:一例全脑畸形患者的病例报告。
IF 3.6 3区 医学 Q2 NUTRITION & DIETETICS Pub Date : 2024-05-27 DOI: 10.1038/s41430-024-01450-8
Manon Le Guiniec, A. L. Borel
Holoprosencephaly is an anomaly in the division of the prosencephalon into cerebral hemispheres during the second month of gestation. Patients can present with early-onset obesity favoured by the cognitive impairment. We present a case of a 24 year-old woman with holoprosencephaly and class III obesity who was treated by 2.4 mg/week SEMAGLUTIDE. Her body weight decreased from 115.3 to 94.3 kg after one-year (18% of total body weight loss). In addition, she presented a marked reduction in self- and hetero-aggressive behaviour when exposed to the sight of food. The treatment was well tolerated, with the exception of a few vomiting when eating palatable food too quickly. GLP1-RAs may be interesting for obesity treatment in the context of neurodevelopmental disorders. They appear to reduce compulsive eating and aggressive behaviour, particularly in relation to exposure to food, and lead to weight loss similar to that seen in people without neurodevelopmental disorders.
全脑畸形是妊娠期第二个月前脑分成大脑半球的异常现象。患者可表现为早发性肥胖,并伴有认知障碍。我们介绍了一例患有全脑畸形和 III 级肥胖症的 24 岁女性病例。一年后,她的体重从 115.3 千克下降到 94.3 千克(体重下降了 18%)。此外,她在看到食物时的自我攻击和异性攻击行为也明显减少。患者对治疗的耐受性良好,只有少数患者在过快进食适口食物时出现呕吐。GLP1-RAs可能对神经发育障碍情况下的肥胖症治疗很有意义。它们似乎能减少强迫性进食和攻击性行为,尤其是与接触食物有关的行为,并能使体重减轻,其效果与未患神经发育障碍的人相似。
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引用次数: 0
Navigating my career in lipid research. 为我的脂质研究事业导航
IF 4.7 3区 医学 Q2 NUTRITION & DIETETICS Pub Date : 2024-05-27 DOI: 10.1038/s41430-024-01452-6
Andrew J Sinclair
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引用次数: 0
Dietary habits and compliance with dietary guidelines in patients with established cardiovascular disease 已确诊心血管疾病患者的饮食习惯和遵守饮食指南的情况。
IF 3.6 3区 医学 Q2 NUTRITION & DIETETICS Pub Date : 2024-05-27 DOI: 10.1038/s41430-024-01443-7
Nadia E. Bonekamp, Johanna M. Geleijnse, Yvonne T. van der Schouw, Jannick A. N. Dorresteijn, Manon G. van der Meer, Ynte M. Ruigrok, Martin Teraa, Frank L. J. Visseren, Charlotte Koopal, On behalf of the UCC-SMART study group
Unhealthy dietary habits are an important risk factor for cardiovascular disease (CVD) and adopting a healthy diet is a central recommendation in CVD prevention. This study assessed the dietary habits of patients with established CVD, their compliance to dietary guidelines, and the relationship between guideline-compliance and recurrent cardiovascular event risk. 2656 patients with established CVD from the Utrecht Cardiovascular Cohort-Secondary Manifestations of ARTerial disease (UCC-SMART) prospective cohort study, were included between 1996 and 2022. Data on dietary intake was retrospectively collected for all participants in December 2022 using a 160-item food frequency questionnaire. Compliance with dietary guidelines was quantified using an amended version of the Dutch Healthy Diet 2015 (DHD-15) index (range: 0–135). Cox proportional hazard models were used to quantify the relationship with cardiovascular events (stroke and myocardial infarction). Among 2656 CVD patients (77% male, mean age 59 ± 9 years), median energy intake was 1922 [IQR: 1536–2351] kcal/day. The median DHD-15 index was 81.7 [IQR 71.2–92.0], with high compliance scores for recommendations on legumes and fish, and low scores for recommendations on whole grains, red meat, processed meat, and dairy. A higher DHD-15 score was associated with lower stroke risk (HR 0.78, 95% CI 0.66–0.92 per 10-point increase) but not with myocardial infarction. Compliance with dietary guidelines was suboptimal in patients with established CVD. High compliance was associated with a clinically significant reduction in stroke risk in patients with established CVD, emphasizing the importance of dietary counseling.
背景:不健康的饮食习惯是心血管疾病(CVD)的重要风险因素,而采用健康饮食是预防心血管疾病的核心建议。本研究评估了已确诊心血管疾病患者的饮食习惯、他们对饮食指南的遵从情况以及指南遵从情况与复发性心血管事件风险之间的关系。方法:研究人员纳入了 1996 年至 2022 年间乌得勒支心血管队列-动脉疾病二次表现(UCC-SMART)前瞻性队列研究中的 2656 名已确诊心血管疾病患者。2022 年 12 月,研究人员使用 160 项食物频率问卷对所有参与者的饮食摄入数据进行了回顾性收集。膳食指南的遵守情况采用修订版的荷兰健康膳食 2015(DHD-15)指数(范围:0-135)进行量化。采用 Cox 比例危险模型量化与心血管事件(中风和心肌梗死)的关系:结果:2 656 名心血管疾病患者(77% 为男性,平均年龄为 59 ± 9 岁)的能量摄入中位数为 1922 [IQR: 1536-2351] 千卡/天。DHD-15 指数的中位数为 81.7 [IQR 71.2-92.0],豆类和鱼类的建议得分较高,而全谷物、红肉、加工肉类和乳制品的建议得分较低。DHD-15得分越高,中风风险越低(每增加10分,HR为0.78,95% CI为0.66-0.92),但与心肌梗死无关:结论:已确诊心血管疾病的患者对饮食指南的依从性并不理想。结论:已确诊心血管疾病的患者对膳食指南的依从性并不理想,而膳食指南的高度依从性与临床上显著降低已确诊心血管疾病患者的中风风险有关,这强调了膳食咨询的重要性。
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引用次数: 0
Exploring the effect of prolonged fasting on kynurenine pathway metabolites and stress markers in healthy male individuals 探索长期禁食对健康男性体内犬尿氨酸途径代谢物和压力指标的影响。
IF 3.6 3区 医学 Q2 NUTRITION & DIETETICS Pub Date : 2024-05-24 DOI: 10.1038/s41430-024-01451-7
Varvara Louvrou, Rima Solianik, Marius Brazaitis, Sophie Erhardt
Prolonged fasting triggers a stress response within the human body. Our objective was to investigate the impact of prolonged fasting, in conjunction with stress, on kynurenine pathway metabolites. Healthy males were divided into fasting group (zero-calorie-restriction) for 6 days (FAST, n = 14), and control group (CON, n = 10). Blood and saliva samples were collected at baseline, Day 2, Day 4, Day 6 during fasting period, and 1 week after resuming regular diet. Plasma levels of kynurenine pathway metabolites were measured using ultra-performance liquid chromatography-mass spectrometry (UPLC-MS/MS). Plasma and salivary samples were analyzed for stress markers. A pronounced activation of the kynurenine pathway in individuals on FAST trial was revealed. Concentrations of picolinic acid (PIC), kynurenic acid (KYNA) and 3-hydroxykynurenine (3-HK) were significantly increased, with peak levels observed on Day 6 (P < 0.0001). Conversely, concentrations of tryptophan (TRP) and quinolinic acid (QUIN) decreased (P < 0.0001), while kynurenine (KYN) and nicotinamide (NAM) levels remained stable. Cortisol and noradrenaline concentrations remained unchanged. However, adrenaline levels significantly increased on Day 4 within FAST compared to CON (P = 0.005). Notably, all deviations in kynurenine pathway metabolite levels returned to baseline values upon resuming regular diet following the 6-day fasting regimen, even when weight and BMI parameters were not restored. Extended fasting over 6 days induces the kynurenine pathway and has minimal effects on stress markers. Restoration of metabolite concentrations upon regular feeding implies rapid adaptation of the kynurenine pathway synthetic enzymes to maintain homeostasis when faced with perturbations.
背景/目的:长期禁食会引发人体的应激反应。研究对象/方法: 健康男性被分为禁食组(零卡路里限制)和对照组(CON,n = 10),禁食组为期 6 天(FAST,n = 14)。在禁食期间的基线、第 2 天、第 4 天、第 6 天和恢复正常饮食后 1 周采集血液和唾液样本。使用超高效液相色谱-质谱法(UPLC-MS/MS)测量血浆中犬尿氨酸途径代谢物的水平。对血浆和唾液样本进行了压力标记物分析:结果:结果表明,FAST 试验参与者的犬尿氨酸通路被明显激活。吡啶甲酸(PIC)、犬尿氨酸(KYNA)和 3-羟基犬尿氨酸(3-HK)的浓度显著增加,在第 6 天达到峰值(P 结论:FAST 试验的结果表明,犬尿氨酸通路在 FAST 试验中被明显激活:延长禁食 6 天可诱导犬尿氨酸途径,对应激指标的影响极小。正常进食后代谢物浓度的恢复意味着犬尿氨酸途径合成酶在面临干扰时能快速适应以维持体内平衡。
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引用次数: 0
Critical outcomes to be included in the Core Outcome Set for nutritional intervention studies in older adults with malnutrition or at risk of malnutrition: a modified Delphi Study 营养不良或有营养不良风险的老年人营养干预研究核心成果集应包括的关键成果:改良德尔菲研究。
IF 3.6 3区 医学 Q2 NUTRITION & DIETETICS Pub Date : 2024-05-23 DOI: 10.1038/s41430-024-01444-6
Nuno Mendonça, Christina Avgerinou, Sibel Çavdar, Tommy Cederholm, Alfonso J. Cruz-Jentoft, Gabriel Torbahn, Cornel Sieber, Hanna M. Siebentritt, Eva Kiesswetter, Dorothee Volkert, Marjolein Visser
As part of the development of an agreed minimum set of outcomes or Core Outcome Set (COS) for future nutritional intervention trials in older adults with malnutrition or at risk of malnutrition, this work reports on the Delphi surveys and final consensus. Outcomes from a scoping review were incorporated into a two-round Delphi survey. Researchers and healthcare professionals experienced in malnutrition in older adults were invited to take part in an online survey to rate 38 selected outcomes on a nine-point Likert scale ranging from ‘not important’ to ‘critical’ for their setting (community, hospital, or long-term care). Consensus for inclusion was reached when ≥75% (or ≥60% if a patient-reported outcome) of the participants scored the outcome as ‘critical’ and <15% as ‘not important’. Resulting outcomes were voted for inclusion or exclusion in the COS in a final online consensus meeting. Ninety-three and 72 participants from diverse professional backgrounds and countries participated in the 1st and 2nd Delphi round, respectively. After both rounds eleven outcomes met the inclusion criteria, largely irrespective of setting. Fifteen participants, representing academia, health care, health policy, industry, and PPI, voted in a final online consensus meeting resulting in ten outcomes: malnutrition status, dietary intake, appetite, body weight or BMI, muscle strength, muscle mass, functional performance, functional limitations, quality of life, and acceptability of the intervention. Ten outcomes will form the COS which is intended to be used by the scientific community in all future nutritional intervention studies for older adults with malnutrition or at risk of malnutrition. The subsequent phase will establish the appropriate methods to measure these outcomes.
导言:作为为未来针对营养不良或有营养不良风险的老年人的营养干预试验制定一套公认的最低结果或核心结果集(COS)的一部分,本研究报告了德尔菲调查和最终共识:方法:将范围审查的结果纳入两轮德尔菲调查。研究人员和对老年人营养不良问题有经验的医疗保健专业人员受邀参加在线调查,按照李克特九点量表(从 "不重要 "到 "关键 "不等)对所选的 38 项结果进行评分。当≥75%的参与者(或≥60%的患者报告结果)将结果评分为 "关键 "时,即达成了纳入共识:来自不同专业背景和国家的 93 名和 72 名参与者分别参加了第一轮和第二轮德尔菲讨论。经过这两轮讨论,有 11 项结果符合纳入标准,基本上与背景无关。代表学术界、医疗保健、卫生政策、工业和公共宣传机构的 15 位参与者在最终的在线共识会议上进行了投票,最终得出了 10 项结果:营养不良状况、饮食摄入量、食欲、体重或体重指数、肌肉力量、肌肉质量、功能表现、功能限制、生活质量和干预的可接受性:十项结果将构成 COS,供科学界用于今后所有针对营养不良或有营养不良风险的老年人的营养干预研究。下一阶段将确定衡量这些结果的适当方法。
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引用次数: 0
Measurement of diamine oxidase (DAO) during low-histamine or ordinary diet in patients with histamine intolerance 组胺不耐受患者在低组胺饮食或普通饮食期间的二胺氧化酶(DAO)测定。
IF 3.6 3区 医学 Q2 NUTRITION & DIETETICS Pub Date : 2024-05-20 DOI: 10.1038/s41430-024-01448-2
Georgios Rentzos, Adina Weisheit, Linda Ekerljung, Jenny van Odijk
Quantification of diamine oxidase (DAO) concentrations in serum has been proposed as an adjunctive diagnostic modality for the evaluation of histamine intolerance (HIT). Limited empirical data exist concerning the influence of dietary patterns on DAO levels. In the context of a prospective study employing a crossover design, 18 individuals diagnosed with HIT were randomized to initiate either a low histamine diet (LHD) or a conventional mixed diet (MXD). Serum DAO concentrations were measured at the commencement of the study and following each dietary phase. A control group underwent analogous DAO assessments without imposition of dietary constraints. During the time when a diet restricted in histamine was implemented, noticeable differences in changes in DAO levels did not become apparent when compared to the changes observed during the mixed (MXD) phase. Specifically, among the group, 10 of the 18 patients exhibited elevated DAO values subsequent to the LHD regimen, while the remaining eight displayed either reduced or unchanging DAO levels. The prevalence of elevated DAO levels in the LHD group did not differ significantly from that observed in the control group during the MXD phase. Additionally, during the LHD phase, patients reported a significant reduction in gastrointestinal and cutaneous symptoms. This prospective investigation underscores the enduring utility of a histamine-restricted diet, coupled with structured dietary reintroduction, as an efficacious diagnostic approach for individuals presenting with suspected food-related histamine hypersensitivity. Notably, the measurement of DAO levels appears to furnish only a limited capacity to discern dietary-induced fluctuations. Notwithstanding, the dynamics of DAO alteration do not appear to exhibit a discernible association with specific dietary patterns, a finding consistent across both patient and control groups.
背景/目的:血清中二胺氧化酶(DAO)浓度的定量分析被认为是评估组胺不耐受(HIT)的一种辅助诊断方法。有关饮食模式对 DAO 水平影响的经验数据有限:在一项采用交叉设计的前瞻性研究中,18名被诊断为HIT的患者被随机分配到低组胺饮食(LHD)或传统混合饮食(MXD)中。在研究开始时和每个饮食阶段结束后测量血清DAO浓度。对照组在不限制饮食的情况下进行类似的 DAO 评估:结果:在实施限制组胺饮食期间,DAO水平的变化与混合(MXD)阶段观察到的变化相比没有明显差异。具体来说,在 18 名患者中,有 10 名患者在接受 LHD 治疗后 DAO 值升高,而其余 8 名患者的 DAO 值要么降低,要么保持不变。在 MXD 阶段,LHD 组 DAO 水平升高的发生率与对照组没有明显差异。此外,在 LHD 阶段,患者的胃肠道和皮肤症状明显减轻:这项前瞻性调查强调了组胺限制饮食和结构化饮食再引入作为一种有效的诊断方法对疑似食物相关组胺过敏症患者的持久效用。值得注意的是,DAO水平的测量似乎只能有限地辨别饮食引起的波动。尽管如此,DAO的动态变化似乎与特定的饮食模式没有明显的联系,这一发现在患者组和对照组中都是一致的。
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引用次数: 0
Mediation effect of body mass index on the association between serum magnesium level and insulin resistance in children from Mexico City 体重指数对墨西哥城儿童血清镁水平与胰岛素抵抗之间关系的调节作用。
IF 3.6 3区 医学 Q2 NUTRITION & DIETETICS Pub Date : 2024-05-14 DOI: 10.1038/s41430-024-01447-3
María Judith Rios-Lugo, Jesús Isimar Serafín-Fabián, Héctor Hernández-Mendoza, Miguel Klünder-Klünder, Miguel Cruz, Estefania Chavez-Prieto, Israel Martínez- Navarro, Jenny Vilchis-Gil, Miguel Vazquez-Moreno
Reduced serum magnesium (Mg) levels have been associated with obesity, insulin resistance (IR), type 2 diabetes, and metabolic syndrome in adults. However, in the children population, the evidence is still limited. In this cross-sectional study, we aimed to analyze the association of serum Mg levels with the frequency of overweight and obesity and cardiometabolic traits in 189 schoolchildren (91 girls and 98 boys) between 6 and 12 years old from Mexico City. Anthropometrical data were collected and biochemical parameters were measured by enzymatic colorimetric assay. Serum Mg level was analyzed by inductively coupled plasma mass spectrometry (ICP-MS). The triglyceride-glucose (TyG) index was used as a surrogate marker to evaluate IR. Serum Mg level was negatively associated with overweight (Odds ratio [OR] = 0.377, 95% confidence interval [CI] 0.231–0.614, p < 0.001) and obesity (OR = 0.345, 95% CI 0.202–0.589, p < 0.001). Serum Mg level resulted negatively associated with body mass index (BMI, β = −1.16 ± 0.26, p < 0.001), BMI z-score (β = −0.48 ± 0.10, p < 0.001) and TyG index (β = −0.04 ± 0.04, p = 0.041). Through a mediation analysis was estimated that BMI z-score accounts for 60.5% of the negative association of serum Mg level with IR (Sobel test: z = 2.761; p = 0.005). Our results evidence that BMI z-score mediate part of the negative association of serum Mg level and IR in Mexican schoolchildren.
背景/目的:成人血清镁(Mg)水平降低与肥胖、胰岛素抵抗(IR)、2 型糖尿病和代谢综合征有关。然而,在儿童群体中,相关证据仍然有限。在这项横断面研究中,我们旨在分析墨西哥城 189 名 6 至 12 岁学龄儿童(91 名女孩和 98 名男孩)的血清镁水平与超重和肥胖频率以及心脏代谢特征之间的关系:收集人体测量数据,并通过酶比色法测量生化参数。采用电感耦合等离子体质谱法(ICP-MS)分析血清镁含量。甘油三酯-葡萄糖(TyG)指数被用作评估 IR 的替代指标:结果:血清镁水平与超重呈负相关(Odds ratio [OR] = 0.377,95% 置信区间 [CI] 0.231-0.614,P 结论:血清镁水平与超重呈负相关:我们的研究结果表明,BMI zcore 是墨西哥学龄儿童血清镁水平与 IR 负相关的部分原因。
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引用次数: 0
24-h energy expenditure in people with type 1 diabetes: impact on equations for clinical estimation of energy expenditure 1 型糖尿病患者的 24 小时能量消耗:对临床能量消耗估算公式的影响。
IF 3.6 3区 医学 Q2 NUTRITION & DIETETICS Pub Date : 2024-05-14 DOI: 10.1038/s41430-024-01446-4
Elvis A. Carnero, Karen D. Corbin, Anna Casu, Daria Igudesman, Anika Bilal, Steven R. Smith, Michael R. Kosorok, David M. Maahs, Elizabeth J. Mayer-Davis, Richard E. Pratley
Type 1 diabetes (T1D) is associated with an increase in resting metabolic rate (RMR), but the impact of T1D on other components of 24-h energy expenditure (24-h EE) is not known. Also, there is a lack of equations to estimate 24-h EE in patients with T1D. The aims of this analysis were to compare 24-h EE and its components in young adults with T1D and healthy controls across the spectrum of body mass index (BMI) and derive T1D-specific equations from clinical variables. Thirty-three young adults with T1D diagnosed ≥1 year prior and 33 healthy controls matched for sex, age and BMI were included in this analysis. We measured 24-h EE inside a whole room indirect calorimeter (WRIC) and body composition with dual x-ray absorptiometry. Participants with T1D had significantly higher 24-h EE than healthy controls (T1D = 2047 ± 23 kcal/day vs control= 1908 ± 23 kcal/day; P < 0.01). We derived equations to estimate 24-h EE with both body composition (fat free mass + fat mass) and anthropometric (weight + height) models, which provided high coefficients of determination (R2 = 0.912 for both). A clinical model that did not incorporate spontaneous physical activity yielded high coefficients of determination as well (R2 = 0.897 and R2 = 0.880 for body composition and anthropometric models, respectively). These results confirm that young adults with established T1D have increased 24-h EE relative to controls without T1D. The derived equations from clinically available variables can assist clinicians with energy prescriptions for weight management in patients with T1D.
背景/目的:1 型糖尿病(T1D)与静息代谢率(RMR)的增加有关,但 T1D 对 24 小时能量消耗(24-h EE)的其他组成部分的影响尚不清楚。此外,还缺乏估算 T1D 患者 24 小时能量消耗的方程。本分析的目的是比较不同体重指数(BMI)的 T1D 青壮年患者和健康对照组的 24 小时能量消耗及其组成部分,并从临床变量中推导出 T1D 特异性方程:本次分析纳入了 33 名确诊 T1D ≥1 年的年轻成人和 33 名性别、年龄和体重指数匹配的健康对照者。我们在全室间接热量计(WRIC)中测量了24小时EE,并用双X射线吸收测定法测量了身体成分:结果:T1D 患者的 24 小时 EE 明显高于健康对照组(T1D= 2047 ± 23 千卡/天 vs 对照组= 1908 ± 23 千卡/天;两者的 P 2 = 0.912)。未纳入自发体力活动的临床模型也产生了较高的决定系数(身体成分模型和人体测量模型的决定系数分别为 R2 = 0.897 和 R2 = 0.880):这些结果证实,与未患 T1D 的对照组相比,已确诊 T1D 的年轻成人的 24 小时 EE 增加了。根据临床可用变量推导出的方程可帮助临床医生为 T1D 患者开出体重管理的能量处方。
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引用次数: 0
Statistical assessment of reliability of anthropometric measurements in the multi-site South African National Dietary Intake Survey 2022 对 2022 年南非全国膳食摄入量调查多站点人体测量可靠性的统计评估。
IF 3.6 3区 医学 Q2 NUTRITION & DIETETICS Pub Date : 2024-05-14 DOI: 10.1038/s41430-024-01449-1
Sanja Nel, Jeroen de Man, Louise van den Berg, Friedeburg Anna Maria Wenhold
Anthropometric data quality in large multicentre nutrition surveys is seldom adequately assessed. In preparation for the South African National Dietary Intake Survey (NDIS-2022), this study assessed site leads’ and fieldworkers’ intra- and inter-rater reliability for measuring weight, length/height, mid-upper arm circumference (MUAC), waist circumference (WC) and calf circumference (CC). Standardised training materials and measurement protocols were developed, and new anthropometric equipment was procured. Following two training rounds (12 site lead teams, 46 fieldworker teams), measurement reliability was assessed for both groups, using repeated measurements of volunteers similar to the survey target population. Reliability was statistically assessed using the technical error of measurement (TEM), relative TEM (%TEM), intra-class correlation coefficient (ICC) and coefficient of reliability (R). Agreement was visualised with Bland-Altman analysis. By %TEM, the best reliability was achieved for weight (%TEM = 0.260–0.923) and length/height (%TEM = 0.434–0.855), and the poorest for MUAC by fieldworkers (%TEM = 2.592–3.199) and WC (%TEM = 2.353–2.945). Whole-sample ICC and R were excellent ( > 0.90) for all parameters except site leads’ CC inter-rater reliability (ICC = 0.896, R = 0.889) and fieldworkers’ inter-rater reliability for MUAC in children under two (ICC = 0.851, R = 0.881). Bland-Altman analysis revealed no significant bias except in fieldworkers’ intra-rater reliability of length/height measurement in adolescents/adults ( + 0.220 (0.042, 0.400) cm). Reliability was higher for site leads vs. fieldworkers, for intra-rater vs. inter-rater assessment, and for weight and length/height vs. circumference measurements. NDIS-2022 site leads and fieldworkers displayed acceptable reliability in performing anthropometric measurements, highlighting the importance of intensive training and standardised measurement protocols. Ongoing reliability assessment during data collection is recommended.
背景:大型多中心营养调查中的人体测量数据质量很少得到充分评估。为准备南非国家膳食摄入量调查(NDIS-2022),本研究评估了现场负责人和现场工作人员测量体重、身长/身高、中上臂围(MUAC)、腰围(WC)和小腿围(CC)的内部和相互之间的可靠性:方法:编制了标准化的培训材料和测量规程,并购置了新的人体测量设备。经过两轮培训(12 个站点领导小组,46 个实地工作者小组)后,使用与调查目标人群相似的志愿者进行重复测量,评估了两组测量的可靠性。使用测量技术误差 (TEM)、相对 TEM (%TEM)、类内相关系数 (ICC) 和可靠性系数 (R) 对可靠性进行统计评估。通过布兰-阿尔特曼(Bland-Altman)分析,可直观地看出测量结果的一致性:根据测量误差百分率,体重(测量误差百分率=0.260-0.923)和身长/身高(测量误差百分率=0.434-0.855)的可信度最高,而实地工作者测量的MUAC(测量误差百分率=2.592-3.199)和WC(测量误差百分率=2.353-2.945)的可信度最低。所有参数的全样本 ICC 和 R 值都非常好(> 0.90),只有站点领导的 CC 评分者间可靠性(ICC = 0.896,R = 0.889)和现场工作人员对两岁以下儿童的 MUAC 评分者间可靠性(ICC = 0.851,R = 0.881)除外。除青少年/成人身长/身高测量的现场工作人员评分内可靠性(+ 0.220 (0.042, 0.400) cm)外,Bland-Altman分析显示无明显偏差。现场引导员与现场工作人员、评分员内评估与评分员间评估、体重和身长/身高测量与周长测量的可靠性都要高:结论:NDIS-2022 现场负责人和现场工作人员在进行人体测量时表现出了可接受的可靠性,突出了强化培训和标准化测量规程的重要性。建议在数据收集过程中持续进行可靠性评估。
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European Journal of Clinical Nutrition
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