中国学者参与制定欧洲肠外肠内营养学会指南：临床营养的定义和术语

　　2016年9月14日，欧洲肠外肠内营养学会（欧洲临床营养与代谢学会）官方期刊《临床营养》在线发表瑞典乌普萨拉大学、意大利的里雅斯特大学、英国牛津大学医院、英国南安普敦大学医院、瑞士温特图尔医院、德国霍恩海姆大学、美国宾夕法尼亚大学、巴西米纳斯吉拉斯联邦大学、日本藤田保健卫生大学、丹麦奥尔堡大学、美国佛蒙特大学、美国西卡梅尔医院、意大利罗马大学、澳大利亚阿尔弗雷德医院、德国伊丽莎白基督教医院、瑞典克里斯蒂安斯塔德大学、奥地利维也纳医科大学、法国尼斯大学阿切特医院、荷兰阿姆斯特丹自由大学医学中心、汉恩应用科学大学、德国埃尔朗根-纽伦堡（弗里德里希·亚历山大）大学圣约翰医院、新勃兰登堡应用科学大学、中国医学科学院中国协和医学院北京协和医院（于健春）、比利时布鲁塞尔自由大学埃拉斯姆总医院、以色列特拉维夫大学赛克勒医学院拉宾医学中心制定的《欧洲肠外肠内营养学会指南：临床营养的定义和术语》。

　　中华医学会肠外肠内营养学分会主任委员于健春教授参与了该指南的制定。

Clin Nutr. 2016 Sep 14. [Epub ahead of print]

ESPEN guidelines on definitions and terminology of clinical nutrition.

Cederholm T, Barazzoni R, Austin P, Ballmer P, Biolo G, Bischoff SC, Compher C, Correia I, Higashiguchi T, Holst M, Jensen GL, Malone A, Muscaritoli M, Nyulasi I, Pirlich M, Rothenberg E, Schindler K, Schneider SM, de van der Schueren MA, Sieber C, Valentini L, Yu JC, Van Gossum A, Singer P.

Uppsala University, Uppsala, Sweden; University of Trieste, Trieste, Italy; Oxford University Hospitals NHS Foundation Trust, United Kingdom; University Hospital Southampton NHS Foundation Trust, United Kingdom; Kantonsspital Winterthur, Winterthur, Switzerland; University of Hohenheim, Stuttgart, Germany; University of Pennsylvania, Philadelphia, PA, USA; Federal University of Minas Gerais, Belo Horizonte, Brazil; Fujita Health University, School of Medicine, Toyoake, Japan; Aalborg University Hospital, Aalborg, Denmark; The University of Vermont College of Medicine, Burlington, VT, USA; Mount Carmel West Hospital, Columbus, OH, USA; Sapienza University of Rome, Italy; Nutrition and Dietetics, Alfred Health, Melbourne, Australia; Elisabeth Protestant Hospital, Berlin, Germany; Kristianstad University, Kristianstad, Sweden; Medical University Vienna, Vienna, Austria; Archet Hospital, University of Nice Sophia Antipolis, Nice, France; VU University Medical Center, Amsterdam, The Netherlands; HAN University of Applied Sciences, Nijmegen, The Netherlands; Friedrich-Alexander University Erlangen-Nürnberg, Hospital St. John of Lord, Regensburg, Germany; University of Applied Sciences, Neubrandenburg, Germany; Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Hopital Erasme, Free University of Brussels, Brussels, Belgium; Rabin Medical Center, Sackler School of Medicine, Tel Aviv University, Petah Tikva 49100 Israel.

BACKGROUND: A lack of agreement on definitions and terminology used for nutrition-related concepts and procedures limits the development of clinical nutrition practice and research.

OBJECTIVE: This initiative aimed to reach a consensus for terminology for core nutritional concepts and procedures.

METHODS: The European Society of Clinical Nutrition and Metabolism (ESPEN) appointed a consensus group of clinical scientists to perform a modified Delphi process that encompassed e-mail communication, face-to-face meetings, in-group ballots and an electronic ESPEN membership Delphi round.

RESULTS: Five key areas related to clinical nutrition were identified: concepts; procedures; organisation; delivery; and products. One core concept of clinical nutrition is malnutrition/undernutrition, which includes disease-related malnutrition (DRM) with (eq. cachexia) and without inflammation, and malnutrition/undernutrition without disease, e.g. hunger-related malnutrition. Over-nutrition (overweight and obesity) is another core concept. Sarcopenia and frailty were agreed to be separate conditions often associated with malnutrition. Examples of nutritional procedures identified include screening for subjects at nutritional risk followed by a complete nutritional assessment. Hospital and care facility catering are the basic organizational forms for providing nutrition. Oral nutritional supplementation is the preferred way of nutrition therapy but if inadequate then other forms of medical nutrition therapy, i.e. enteral tube feeding and parenteral (intravenous) nutrition, becomes the major way of nutrient delivery.

CONCLUSION: An agreement of basic nutritional terminology to be used in clinical practice, research, and the ESPEN guideline developments has been established. This terminology consensus may help to support future global consensus efforts and updates of classification systems such as the International Classification of Disease (ICD). The continuous growth of knowledge in all areas addressed in this statement will provide the foundation for future revisions.

KEYWORDS: Clinical nutrition; Consensus; Definition; Malnutrition; Medical nutrition; Terminology

PMID: 27642056

PII: S0261-5614(16)31242-0

DOI: 10.1016/j.clnu.2016.09.004