Endocrine Abstracts

Introduction: Undernutrition is a pernicious and frequent situation that often remains undetected and insufficiently treated. The aim of our study was to determine the prevalence of malnutrition in adult patients seen in specialized nutrition consultation.

Materials and methods: It was a cross-sectional study, including adult patients consulting our specialized nutrition unit in the outpatient department and functional exploration of the National Institute of Nutrition of Tunis. Demographics, clinical characteristics, biochemistry and outcome data were collected. Among the phenotypic criteria, we find the muscular strength, evaluated by the Hand Grip test (HG), the body mass index (BMI) and weight loss (WL). Their limits were those defined by the high health authority (HAS) 2021. One of these criteria associated with an etiological criterion establishes the diagnosis of malnutrition. We also measured the upper arm circumference (AC) and calf circumference (CC).

Results: Thirty five patients with the mean age of 35.14 ±15.95 years [20; 68] were included in the study. The sex ratio was 0.2. The main reported symptoms were anorexia (54.3%) and asthenia (34.3%). The average BMI, WL, HG, AC and CC were 17.51±4.3 kg/m²; 15.83±9.63%; 23.27±10.1 kg; 22.89±3.18 cm and 30.82±4.11 cm respectively. The prevalence of undernutrition with BMI, WL and HG as isolated criteria were 74.28%, 65.71% and 31.42%, respectively. It was 65.71% associating at least a phenotypic and an etiological criterion as the HAS recommends. The undernutrition was moderate in 43.47% of cases and severe in 56.52% of them. Severity was related to a BMI under 17 kg/m²; in 84.61% of cases, to WL greater than 15% in 61.53 % of cases and to an albumin level under 30g/l in 15.38 % of them. BMI was significantly correlated with age (P=0.05), upper arm circumference (P<0.0001) and calf circumference (P=0,006) but no correlation was found with HG and WL. Undernutrition was correlated with WL (P=0,001).

Conclusion: The presentation of undernutrition is often subtle and there is a need to pay additional attention to nutrition status by the use of reliable screening toolsand increasing physician awareness. HAS recommendations constitute an appropriate tool to establish a malnutrition situation and should be applied whenever this diagnosis is suspected.