Abstract:Objective To analyze the nutritional status of hospitalized patients with type 2 diabetes mellitus (T2DM). Methods Using fixed-point continuous sampling, 512 cases of hospitalized patients with T2DM were screened for nutritional risk by nutritional risk screening 2002(NRS 2002), and relevant biochemical indicators were collected to analyzed the relationship with gender, age, disease course and relevant biochemical indicators. The status of nutrition was determined by hospitalized patients’ body mass index (BMI), with BMI<18.5 indicating malnutrition,24≤BMI<28 indicating overweight,and BMI≥28 indicating obesity. Results The incidence of nutritional risk in 512 hospitalized patients with T2DM was 18.0%, and the incidence of malnutrition, overweight, obesity were 2.5%, 35.9% and 8.6%, respectively. The incidence of nutrition risk was higher in men than that in women, but there was no statistical difference (P<0.05). The incidence of nutrition risk in ≥70 years hospitalized patients with T2DM was higher than that in two aged groups<60 years and 61~69 years (P<0.05). There was no difference in the incidence of nutrition risk in the course of disease (P<0.05). Compared with hospitalized patients with no nutrition risk diabetes, hospitalized patients with nutrition risk diabetes had higher HbA1c、ESR、Bun、SCr (P<0.05). With hospitalized T2DM with nutritional risk as the dependent variable, age, HbA1c、ESR、Bun、SCr as independent variables, multiariable Logistic regression analysis, the results showed that age and HbA1c are the related risk factors for nutrition risk of T2DM. Conclusion The nutritional status of T2DM is not optimistic; therefore it is necessary to strengthen nutrition risk screening, evaluation, intervention and health education.
施汉平,梁肖肖. 2型糖尿病住院患者营养状况分析[J]. 肿瘤代谢与营养电子杂志, 2019, 6(3): 342-345.
SHI Han-ping, LIANG Xiao-xiao. Analysis of nutritional status of hospitalized patients with type 2 diabetes mellitus. Electron J Metab Nutr Cancer, 2019, 6(3): 342-345.
1.Xu Y, Wang L, He J, et al. Prevalence and control of diabetes in Chinese adults. JAMA. 2013;310(9):948-959.
2.Mueller C, Compher C, Ellen DM. A.S.P.E.N. clinical guidelines: Nutrition screening, assessment, and intervention in adults. JPEN J Parenter Enteral Nutr. 2011;35(1):16-24.
3.Mohammad S, Ahmad J. Management of obesity in patients with type 2 diabetes mellitus in primary care. Diabetes Metab Syndr. 2016;10(3):171-181.
4.Kondrup J, Rasmussen HH, Hamberg O, et al. Nutritional risk screening (NRS 2002):a new method based on an analysis of controlled clinical trials. Clin Nutr. 2003;22(3):321-336.
5.Kondrup J, Allison S P, Elia M, et al. ESPEN guidelines for nutrition screening 2002. Clin Nutr. 2003;22(4):415-421.
6.McClave SA, Taylor BE, Martindale RG, et al. Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.). JPEN J Parenter Enteral Nutr. 2016;40(2):159-211.
7.McClave SA, DiBaise JK, Mullin GE, et al. ACG clinical guideline: nutrition therapy in the adult hospitalized patient. Am J Gastroenterol. 2016;111(3):315-334,335.
8.中华医学会. 临床诊疗指南-肠外肠内营养学分册. 北京: 人民卫生出版社, 2009:111.
9.于康, 蒋朱明, 毛一雷, 等. 中华人民共和国卫生行业标准(WS/T427—2013):临床营养风险筛查. 北京: 中华人民共和国国家卫生和计划生育委员会, 2013.
10.许静涌, 杨剑, 康维明, 等. 营养风险及营养风险筛查工具营养风险筛查2002临床应用专家共识(2018版). 中华临床营养杂志. 2018;26(3):131-135.
11.杨剑, 蒋朱明, 于康, 等. 营养不良评定(诊断)标准沿革及目前存在问题的思考. 中华外科杂志. 2019;57(5):331-336.
12.石汉平, 赵青川, 王昆华, 等. 营养不良的三级诊断. 肿瘤代谢与营养电子杂志. 2015;2(2):31-36.
13.石汉平. 营养筛查与评估. 北京: 人民卫生出版社. 2014:152.
14.Soeters P, Bozzetti F, Cynober L, et al. Defining malnutrition: a plea to rethink. Clin Nutr. 2017;36(3):896-901.
15.李月秋, 赵江, 王维利, 等. 住院患者营养风险筛查研究现状与展望. 中华现代护理杂志. 2011;17(16):1965-1968.
16.Xu J, Jiang Z. Different risk scores consider different types of risks: the deficiencies of the 2015 ESPEN consensus on diagnostic criteria for malnutrition. Eur J Clin Nutr. 2018;72(7):936-941.
17.Zhu M, Wei J, Chen W, et al. Nutritional risk and nutritional status at admission and discharge among chinese hospitalized patients: a prospective, nationwide, multicenter study. J Am Coll Nutr. 2017;36(5):357-363.
18.张德桂, 张会, 徐咏梅, 等. 营养风险筛查2002在住院糖尿病患者营养筛查中的应用. 中国临床保健杂志. 2015(5):538-539.
19.袁静珏, 蔡东联. 糖尿病患者营养风险筛查和营养评价. 医学研究杂志. 2010;39(2):35-37.
20.康婷, 张燕, 李丽, 等. 上海市部分地区住院糖尿病患者营养状况调查. 上海医学. 2011;34(9):672-674.
21.李惠萌, 史文丽, 马向丽. NRS 2002和SGA在不同体质指数2型糖尿病患者中的应用研究. 实用预防医学. 2014;21(12):1525-1528.
22.潘素琼, 陈晓, 陆媚英, 等. 2型糖尿病住院患者456例营养风险筛查分析. 广西医学. 2016;38(5):681-683.
23.Miguel L, Julia AH, Mercè P, Abelardo GL,et al. Prevalence of hospital malnutrition in patients with diabetes mellitus:a sub-analysis of the predycES Study[Z]. 2015:1, 1018.
24.Wu Y, He Y, Chen F, et al. Nutritional risk screening in patients with Crohn’s disease. Zhonghua Yi Xue Za Zhi. 2016;96(6):442-446.
25.Aibana O, Acharya X, Huang CC, et al. Nutritional status and tuberculosis risk in adult and pediatric household contacts. PLoS One. 2016;11(11):e166333.
26.张艳, 汪婷, 康冬梅. 老年糖尿病住院患者营养状况及影响因素. 中国老年学杂志. 2018;38(12):2842-2844.
27.Park HC, Lee YK, Cho A, et al. Diabetic retinopathy is a prognostic factor for progression of chronic kidney disease in the patients with type 2 diabetes mellitus. PLoS One. 2019;14(7):e220506.
28.孔建华, 张洁, 滑莹莹, 等. 营养风险筛查在老年糖尿病肾病患者营养评估中的应用. 中国临床保健杂志. 2017;20(1):58-60.
29.Dye C, Bourdin TB, Lonnroth K, et al. Nutrition, diabetes and tuberculosis in the epidemiological transition. PLoS One. 2011;6(6):e21161.