DIAGNOSTIC VALIDITY OF THE PHYSICAL-EXAMI NATION IN SCREENING FOR MICRONUTRIENT DEFICIENCIES - VITAMIN-D, CALCIUM, PHOSPHORUS, MAGNESIUM AND ZINC IN HIGH-RISK SUBJECTS

This clinical study was conducted to assess the diagnostic validity of physical examination to detect micronutrient deficiencies. The sample included 79 participants (52-93 y.); among them, 66 were at risk of p rotein-energy malnutrition (Pad). A standardized physical examination was performed. The frequency of clinical signs related to vitamin D, c alcium, phosphorus, magnesium, and zinc deficiencies was assessed. A b lood rest was done. Biochemical signs of deficiencies for one or sever al micronutrients were found in 33 patients (42%). The physical examin ation detected 8 cases of zinc: deficiency among 25 patients with low serum zinc, 3 loses of osteomalacia among 13 patients with low serum 2 5-OH vitamin D and 3 loses of magnesium deficiency among 6 patients wi th low serum magnesium. On the whole, 9 patients, all at risk of PEM, had one or more clinical micronutrient deficiencies. Among clinical si gns associated with biochemical signs of nutrient deficiencies (i.e. p redictive clinical signs found with chi-square tests), the best predic tive signs of deficiencies found by the logistic regression analysis a re hepalomegaly and ataxia (Romberg sign) with regard to serum zinc, a bdominal pain and nystagmus with regard to serum magnesium, and anorex ia with regard to serum albumin. Our preliminary results concerning a limited number of nutrients argue for the more frequent use of physica l examination in the nutrition assessment of individuals nutritionally -at-risk.