~ • TAP CHi NGHIEN CLPU Y HOC
TiNH TRANG DINH DU'O'NG NGU'O'I CAO TUOI TAI VIEN LAO KHOA NAM 2010
Nguyin Thj Cim Nhung\ Pham Duy Tudng^
^Benh vi$n Nqi tie! Nghe An, ^Trwong Dai hpc YHa Noi Nghien cuv nhdm ddnh gid tinh trang dmh dwang cua nguui cao tudi tai vidn Lao khoa Tmng uvng Thidt ke nghien ciiu md ta cdt ngang Phdng vdn tpic tidp 200 bdnh nhan trdn 60 tudi bdng bp cau I161 thidt kd sin Danh gid tinh trang dtnh dwdng bdng chl sd khdi co the (BMI) va nguy co beo bung bdng chl sd vong b[ing/vong mdng Kdt qua cho thay BMI trung binh chung Id 20.96 ± 2,46. BMI tmng binh cua cu dng (21.69
* 2.03) cao hon BMI cua cu ba (20,59 ±2.75) vcn p < 0.05 Co 15% cdc cu thiea cdn. 6%, cu beo phi dp I (BMI > 25). Co 15%, tdng sd cdc cu cd BMI < 18.5. trong do cu ba (23.1%,) cao hon cu dng (6.2%) vdi p < 0,05 Ty sd vdng bung/vdng mdng trung binh chung Id 0.89 ± 0,04. Cdc ca ba cd nguy co bdo bung la 89,4% cao hon cdc cu dng Id 60.4% (p < 0.05) Sd lieu nghien cuv la co sd cho viec xdy dwng ngudng can thi^p hop ly
Tir khoa: tinh trang dinh dudng, chi s6 kh6i c c the, vong bung, vong mong
I. OAT VAN D^
Tnang nhCrng nam g i n day ciing vdi su t i i n bo VLPCTt bac eua y hoc iam sang eung nhu y hoc dir phdng tuoi tho eon ngudi da tang len, dac biet la ngudl gia Theo t h i n g kg eua to chuc lign hop quic (UN) s i ngudi t u 60 tuoi trd len tren Sii gidi nam 1950 la 201 tneu ngudi, nam 1985 la 432 tngu ngudl, nam 2000 la 590 tneu ngudi va udc linh d i n nam 2025 se la 1 ty 201 trigu ngirdi [1], Be ngudi cao tuoi cd mdt sue khoe tot, CO cudc song y nghTa va hanh phue vdi gia liinh, ban be, xa hdi trd ngn quan trong va can thik Da ed mot s i nghien cuu v i tinh trang dmh du'&ng cua ngudi cao tuoi duac t i i n hanh d ndi tiianh Ha Ndi [2] va vung trung du B i c Bd [3]
Mac dil da cd nghien ciru d benh vign nhung IJ6I tux^ng cdn han hep [5] Dh tai nghign ciru nhim muc tigu danh gia tinh trang dmh dudng cua ngudl eao tuoi tai vign Lao khoa Trung iwng va dua ra nhirng k h u y i n nghi phii hop
O/a Chilian h$ Pham Duy Tuvng. Vien Dao (90 V hac dir Plxfig va Y ti cong cong. Tnrong Dai hoc Y Ha NQI
^il-pdtuong@yahoo com
^Qsynhan 05/02/2013 '^Qs/i3uoc chap thuan 20/6/2013
II. 061 TU'O'NG VA PHU'aNG PHAP
1. Ddi t y a n g
Bgnh nhan tuoi tir tren 60, n i m d i i u In 1 tuan d i u tai benh vien d i eae sd do nhan trie i n dmh
2. Dja d i i m va t h d i gian
- Tai cac khoa Tim mach. T h i n kmh, Ndi tdng hap. Ndi t i i t - Chuyin hda cua vien Lao khoa Trung uang, quan Ddng Da, Ha Ndi
- Thai gian nghien ciru tir 31/12/2009 d i n 31/3/2010
3. T h i l t k§
Nghign ciru duac thiit k i theo phuang phap cat ngang md ta Thu thap sd iigu thdng qua phong van true t i i p benh nhan bing bd cau hdi thiel k i s i n
4. C d m l u : Dimg edng thire udc luong mdt ty le trong q u i n t h i eho d i i u tra eit ngang
= 2- (l-n/Z) X p ( 1 - p )
KNCYH 83 (3) - 2013
TAP CHI NGHIEN CU'U Y HQC Trong d6, n c& m i u nghi6n cu'u, Z^,,, ^m he so tin cay (= 1,96), chpn a = 0,05, p 14 ty IS cac cu bi thi^u nSng lu-grng tru'(^ng dien trong nghiSn CLTU tru'ftc (p = 15,0%) , e' Khoang sai I6ch mong mu6n chgn = 0,06 Tinh airp'C, n = 196 doi tupng Tinh ty l§ b(5 cuOc vS iam trdn so n = 200
5, Danh gid t i n h t r a n g d i n h du'O'ng S u dung chi so khoi co th6 (BMI) theo khuyen cao cua To chii'c Y lk lt\k gi&i k h u y i n nghi cho ngu'6'i ChSu A nhu sau BMI £ 25 bfeo phi, BMI i 23 - 24,9 thira can, BMI tir 18,5 - 22,9 binh thudng BMI s 18,5 thiSu nang lu'png tru'b'ng d i i n (CED) v a chi s6
vdng bung/vdng mdng VBA/M > 0,8 cd nguy c d bdd bung ddi vdi nO', VBA/M > 0,9 doi vdl nam
6. Phu'O'ng p h a p xtp ly, phSn t i c h s 6 lieu XCr ly va phan tich Sd lidu trSn phan mem EPI- INFO 6 04 c a c test thong kS y hoc thdng thudng d u p c si> dung
7. D a d dii'C n g h i e n c i r u
Nghidn c u u d u p c s u cho phdp cua bpnh vi$n, dpi t u p n g nghi6n ciru d u p c giai thich v§
muc dich va t u nguydn tham gia, 6\sac riit khdi nghidn ciru bat ki iuc nao va mpi thdng tin chi s u dung cho muc dich nghidn ci>u-
1. KET QUA
1. Tinh trang d i n h d u d n g cua cac c u cao t u d i t h e o c h i s d k h d i co- t h i Bang 1. BIV1I t r u n g b i n h phan loai t h e o n h d m t u d i
Cu o n g (96) Cu ba(104) C h u n g (200)
n BMI ( / f i t SDI n B M I ( / ( ' : ± S D ) n BMI ( ^ ± SD)
60 - 69 t u d i ' 70 - 79 tuoi 80 - 89 tuoi 90 - 99 tuoi Trung binh '
32 36 27 2
21,69 ± 2 , 1 2 21,92+ 1,97 21,28 ± 1,99 19,64+ 1,69 21,61 ± 2 , 0 3
.30 37 30 7
20,32 ± 2 , 2 2 21,01 ± 2 , 7 7 20,29 ± 2,66 17,25 ± 2 , 0 0 20,35 ± 2 , 6 7
62 72 57 9
21,03 ± 2 , 2 6 21,45 ± 2 , 4 4 20,76 ± 2,40 17,70 ± 2 , 1 1 20,96 ± 2,46
(" c6 y nghia thdng ke v&i p < 0,05).
Bang 1 cho t h i y nhdm tuoi 70 - 79 cd ehi sd BMI cao n h i t la 21,45 ± 2,44, BMI ed xu hudng giam d i n theo luoi, va thap nhat d nhom tuoi 90 - 99 la 17,7 ± 2,11 -Chl so BMI eua cu dng d l i t ca cac nhdm luoi deu eao hon eua cu ba, s u khae biet nay d nhdm luoi 60 - 69 ed y nghTa thong kg (p < 0,05} BMI trung binh chung la 20,96 ± 2,46, BMI trung binh cua eu dng (21,69 ± 2,03) eao han BMI eiia cu ba (20,59 ± 2,75) S u khac bigt cd y nghia thong kg p < 0,05
TCNCYH 83 (3)-2013
• T^P CHI NGHIEN CLKU Y HOC Bang 2. Tinh trang thira can va beo phi ciia cac cu theo BMI
Chi s6 BMI Beo phi dd 1 Thira can Binh thudng *
G i d i - Cu n.
7 13 70
dng (96)
%
7,3 13,5 72,9
C u b a
"2 6 17 58
(104)
%
4,8 16,3 55,8
Chung (200) n % 12 6,0 30 16,0 128 64,0
Cd 64% cac eu ed BMI binh thudng, trong do cu dng (72,9%) cao han cu ba (55,8%) vdi p<0,05 Cd 15% c a e c u thuacSn, 6% cu beo phi do I (BMI > 25), khdng c d s u khac biet giua eu ong va eu ba (p > 0,05) Khdng cd cu nao cd BMI > 30,
Bang 3. T i n h trang t h i i u nang l u a n g t r u d n g d i i n ciia cac cu theo BMI
— — ^ _ ^ ^ ^ G l d i Chisd BMI ~~ —-—____^_^
Thiiu nang lupng trudng d i i n chung*
CED d d i CED do II CED do Ili
Cu ong (96) n.
6 6 0 0
%
6,2 6,2 0,0 0,0
Cu n2 24 11 9 4
ba (104)
%
23,1 10,6 8,7 3,8
Chung (200) n % 30 15,0 17 8,5 9 4,5 4 2,0
C cd y nghia thdng ke vai p < 0,05)
Cd 15% long s i cac cu cd BMI < 18 5, trong dd cu ba (23.1%) cao han cu dng (6,2%), su khac biet cd y nghTa t h i n g ke voi p < 0,05, khdng cd eu dng nao CED II va III
2. Tinh trang d i n h d u d n g cua cac cu theo chi sd v d n g bung/vdng mdng Bang 4. Ty s d v d n g b u n g / v d n g m d n g trung binh va nguy c a beo bung cua cac cu
V B / V M - ^ ^ " ' Trung binh *
Nguy CO beo bung' n 96 n 58
Cu dng VB/VIVI(Zi ±SD)
0,90 ± 0 , 0 3
%
60,4 104
n 93
Cu ba V B / V M ( 2 ! ±SD)
0,88 ±0,06
%
89,4 200
n 151
Chung VBA/M (? ± SD)
0,89 + 0,04
%
75,5
"^' {' CO y nghia thdng ke vai p < 0,05)
* l/B/VM VOng bung/vdng mong
Bang 4 chi ra rang vdng bung/vdng mdng trung bmh chung la 0.89 ± 0,04 Ty sd vdng bung/
»6ng mdng cua cu dng (0,9 ± 0,03) cao hon cu ba (0,88 ± 0,05), s u khac biet cd y nghTa thdng ke
* l p < 0,05 Hon nu'a cac cu ba cd vong bung/vong mong > 0,8 la 89,4% cao hpn hSn cac cu
<m CO vdng bung/vdng mdng > 0,9 la 60,4% (vdi p < 0,05), co 75,5% cu cd nguy co beo bung, (w ba cd nguy c d beo bung cao hpn cu dng
KNCYH 83 (3)-2013
TAP CHI NGHIEN CU'U Y HQC
IV. BAN LUAN
Tinh trang dinh d u d n g cua cdc cu c a o t u d i theo chi s d BMI
BMI trung binh chung eiia cac CM la 20,96, BMI trung binh eua cu dng eao han CM ba (21,69 so vdi 20,59) khac bi^t ed y nghTa thong kg Theo k i t qua nghidn ciru T r i n Dinh Toan Irgn doi tugng la cac can bd vign chuc tren 45 lu6i thi BMI trung binh cua doi tuong nam la 20,55, ciia nu' la 20,75 [5] thi BMI eiia cac cu d vi^n Lao khoa cao han eae can bO vien chirc kham lai b^nh vign Vigt Xd (BMI cua eu ba t h i p han),
Trong nghien ciru cua ehiing ldi cd 2 1 % ty le cae eu thii'a can bgo phi, trong dd cu dng la 20.8% va cu ba la 2 1 , 1 % , khdng ed s u khac bigl giua hai gidi Theo Nguyen Xuan Tu nghign ciru tai xa Tam Hung (2004) ty le thira can beo phi la 10%, trong do cu ba (11,4%) cao han cu dng (6%) [6] va Truang Thi ThiJy Duong (2009) doi t u a n g 55 - 65 tuoi tai phudng Kim Lien - Ha Ndi thi ty le thira can beo phi la 36,7% trong dd ed 1 % la beo phi dd II (BMI > 30} [7]
Ve ty le t h i i u nang luang trudng d i i n (CED) Chung la 15% trong dd ed 4,5% la CED II va 2% CED III va deu g i p d cu ba K i t qua eua ehiing tdi t h i p han n h i i u so vdi eae CM d xa Tam Hung (2004) la 44,7% [6]
Tinh trang dinh d u d n g cua cac c u t h e o chi s d v d n g b u n g / v d n g m d n g
Theo mdt so tai lieu thi ty so vdng bung/
vong mdng eao > 0.9 d i i vdi nam va > 0,8 doi vdl nu la mdt d i u hieu cua bgnh tat, dac bigt la cae benh ve tim mach, tang h u y i t ap. dai thao dudng Ty le vdng bung/vong mdng cao da duac chap nhan nhu la mdt phuang phap lam sang de xae dinh co lich luy m d d bMng (beo bung) [4] K i t qua nghidn ciru cho thay
89,4% cy ba ed vdng bung/vong mdng > 0,8, 60,4% ey dng cd vdng bung/vdng mdng > 0,9, Cd 75,5% cu cd nguy ea beo byng, ey ba cd nguy c o bgo bung cao han cu dng (vdi p < 0,05) K i t qua nghien c u u v i ty le cac eu ed nguy ea bao bung d i u eao cd the do cae cy t u i i da eao it di lai va It hoat ddng t h i luc.
V. K t T LUAN
BMI trung binh ehung la 20.96 ± 2,46, BMI trung binh eiia eu dng (21,69 ± 2,03) cao han BMI eua cy ba (20.59 ± 2,75) vdi p < 0,05 Cd 15% cac cu thua can, 6% cy beo phi dd I (BMI
> 25) Cd 15% long s6 cac cu cd BMI < 18.5, trong dd eu ba (23,1%) eao han cu dng (6,2%) vdl p < 0,05. Ty so vdng bung/vdng mdng trung binh ehung la 0.89 ± 0,04, ty sd vdng bung/vdng mdng cua cu dng (0,9 ± 0,03) cao han ey ba {0,88 ± 0,05) vdi p < 0,05 Cae eu ba cd nguy c a beo bung la 89,4% cao han cac cu dng la 60,4% (p < 0,05)
Lai cam en
Xm ehan thanh cam a n Ban giam ddc vign Lao khoa Trung u o n g va toan the cac d i i tuang tham gia nghien ciru da giiip d d chung tdl thue hien nghien c u u nay
TAI LIEU THAM KHAO
1. U.S. Bureau of the Census'(1998).
World Population Profile 1 - 2
2. Pham Duy T u d n g (2003). Tinh trang va tap tinh an udng cua cae cy cao tuoi tai Lang Ha, D i n g Da, Ha Ndi Y hoc thwc hanh, s i 4 4 0 , 1 4 - 1 7
3. Pham Duy T u d n g , N g u y i n Thanh T u i n va Vu Duy Kien (2001) Tap tinh an u i n g eua n g u d i eao luoi tai xa Lap Thach, huyen Lam Thao, tinh Phu Tho Nghidn cwu y hoc, phu ban 20 (4), 233 - 238
TCNCYH 83 (3) - 2013
TAP CHi NGHIEN CCfU Y HOC
4. Bo Y ti, vien Dinh du'&ng (1998). cac cu cap tu6i p xa Tam Hung - Thanh Oai - mr*ng d i n danh gia tinh hinh dinh dudng va Ha Tay, Y hoc di/ phOng, tap XVI, s6 3 t 4 tilLrc phim p mpt cpng ddng Nha xuSt biin y (83), 1 6 - 2 0
te, 6 9 - 6 0 , 7 2 - 7 3 7 p^am Duy Tup.ng, Le Thi Hu-png, 5. Iran Binh Toan (1997). Mpt s6 chi tiSu Tru.png Thj Thuy Dupng, Dinh THi Le Thuy ntian trac dmh duc-ng cua can bd vien chu'c
tren 45 tuoi qua 3 lan dieu tra 1990, 1993 va 1996, VSPD,s6 1,61 - 6 5
6. Pham Duy T u i n g , Nguyin Xuan Tu ,^y,^^^„^ ^ , ^^^^ ^^^ ^^^
(2006). Tap tinh va linh trang dmh dudng eua
(2010). Higu qua ciia t u v i n dmh dudng tdi roi loan Lipid mau d nguditrudng thanh 55 - 65 tuoi lai phudng Kim Lien - Ha Ndi V /7pc
Summary
NUTRITIONAL STATUS OF THE ELDERLY AT THE INSTITUTE OF NATIONAL GERONTOLOGY 2010
The research vi^as lo assess the nutntional status of the elderly at the National Genatric Insti- tute by the Cross-seelional descriptive study design Direct interview was conducted with 200 patients over 60 years old using the pre-designed queshonnaire The nutntional status was assessed by body mass index (BMI) and the nsk of abdominal obesity by waist /Hip circumfer- ence index The results showed that the average BMI was 20 96 ± 2 46, in which the average BMI of the male population (21 69 ± 2 03) is higher than the female population (20 59 + 2 75) with p < 0.05 Ovenveight is accounted for 15% and grade I obesity (BMI > 25) is 6% The rate with m\< 18 5 is 15%, female (23 1%) is higher than male (6 2%) with p < 0 05 The ratio of VB/VM average is 0 89 ± 0 04, The old woman at nsk of abdominal obesity was 89 4% higher than man at 60 4% (p < 0 05) This research data is the basis for the development of an appropnate intewention threshold
Keywords: nutritional status, body mass index, waist circumference, hip circumference
TCUCYH 83 (3) - 2013
