■多发性硬化症(MS)患者有许多潜在因素(疾病持续时间,痉挛,固定化,或糖皮质激素的使用)可能会恶化其营养状况并影响疾病的进展和预后。身体质量指数(BMI),最广泛使用的营养状况评估工具,具有重要的局限性,因为它不提供有关身体成分的任何数据。
本研究旨在通过使用生物电阻抗分析(BIA)评估体重指数(BMI)和身体成分的营养状况评估与体重不足/脂肪不足诊断的一致性之间的相互关系。正常体重/健康,超重/超重,和肥胖/肥胖MS患者。
■在176例MS患者中评估了人体测量[BMI和腰围与身高比(WHtR)]和身体成分(BIA)数据。患者分为四个营养状况亚组(体重不足,正常体重,超重,根据BMI肥胖,脂肪不足,健康,脂肪过多,根据BIA的脂肪质量%和肥胖)。扩展的残疾状态量表评分中位数为4.5。然后根据EDSS评分将患者分为轻度(EDSS1.0-4.0)或中度(EDSS4.5-6.5)残疾亚组。
■基于BIA评估,基于BMI[n=50(28.41%)与超重的患病率明显高于超重的患病率n=38(21.59%);p<0.05]。然而,无论诊断方式如何,肥胖的患病率都没有显着差异,并且在使用BIA评估时也没有显着降低[n=26(14.77%)与n=30(17.05%),分别]。对于所有MS患者以及轻度和中度亚组,使用BMI和BIA进行诊断的总体兼容率(CR)分别为75.6%,77.0%和70.1%。分别。在超重组中观察到最低CR。在所有亚组中,肥胖显著低估了BMI。在中度MS亚组中,BMI将MS患者显著过度分类为具有正常体重(p<0.05)。腹部肥胖的分层(WHtR>0.5)表明,BMI明显低估了超重和肥胖的MS患病率。肥胖和肥胖的病人,使用BIA评估(60.5vs.67%;p<0.05)。临床状态(EDSS和ΔEDSS)与使用BIA评估的FAT%分类的营养状况比使用BMI截止点更密切相关。然而,这种关系没有统计学意义.
■使用BMI截止点来评估MS患者的营养状况与过度脂肪量的明显低估有关。在MS患者中,基于BIA的FAT%与腹部肥胖和残疾状态的关系比与BMI的关系更好。假阴性诊断率最高的是基于MS和中度残疾患者的BMI。使用BIA进行脂肪评估似乎是对患者组进行适当营养状况评估的有用方法。
UNASSIGNED: Patients with multiple sclerosis (MS) have many potential factors (disease duration, spasticity, immobilization, or glucocorticoid use) that can deteriorate their nutritional status and impact both the progression and prognosis of the disease. Body mass index (BMI), the most widely used nutritional status assessment tool, has important limitations because it does not provide any data on body composition.
UNASSIGNED: This study aimed to assess the interrelationship between nutritional status assessment by both body mass index (BMI) and body composition using bioelectrical impedance analysis (BIA) and the consistency of diagnosis for underweight/underfat, normal weight/healthy, overweight/overfat, and obesity/obese MS patients.
UNASSIGNED: Anthropometric [BMI and waist-to-height ratio (WHtR)] and body composition (BIA) data were evaluated in 176 patients with MS. Patients were categorized into four nutritional status subgroups (underweight, normal weight, overweight, obese according to BMI, and underfat, healthy, overfat, and obese according to fat mass% by BIA). The median Expanded Disability Status Scale score was 4.5. Patients were then divided according to EDSS score as mild (EDSS 1.0-4.0) or moderate (EDSS 4.5-6.5) disability subgroups.
UNASSIGNED: Based on BIA assessment, there was a significantly higher prevalence of overfat than of overweight based on BMI [n = 50 (28.41%) vs. n = 38 (21.59%); p < 0.05]. However, the prevalence of obesity did not differ significantly regardless of the mode of diagnosis and was not significantly lower when assessed using BIA [n = 26 (14.77%) vs. n = 30 (17.05%), respectively]. The overall compatibility rates (CR) of diagnoses made using both BMI and BIA were 75.6, 77.0, and 70.1% for all patients with MS and the mild and moderate subgroups, respectively. The lowest CR was observed in the overweight group. Adiposity significantly underestimated BMI in all subgroups. In the moderate MS subgroup, BMI significantly overcategorized patients with MS as having a normal weight (p < 0.05). Stratification for abdominal obesity (WHtR > 0.5) showed that BMI significantly underestimated the prevalence of MS in overweight and obese vs. overfat and obese patients, as assessed using BIA (60.5 vs. 67%; p < 0.05). Clinical status (EDSS and ΔEDSS) was more closely related to the nutritional status categorized by FAT% assessed using BIA than using BMI cutoff points. However, the relationship was not statistically significant.
UNASSIGNED: Using the BMI cutoff point for nutritional status assessment in patients with MS is associated with a significant underestimation of excess fat mass. BIA-based FAT% based on BIA have a better relationship with abdominal obesity and disability status than with BMI in patients with MS. The highest rate of false-negative diagnoses was based on the BMI in patients with MS and moderate disability. Adiposity assessment using BIA appears to be a useful method for proper nutritional status assessment in the patients group.