NRS2002、SGA和MNA-SF评估2型糖尿病住院病人营养状况的结果比较

Comparison of NRS2002,SGA and MNA-SF in assessing nutritional status quo of inpatients with type 2 diabetes

[目的]应用营养风险筛查2002 (NRS2002)、主观全面评价(SGA)和简易营养评价精法(MNA-SF)评价2型糖尿病住院病人营养状况,并对结果进行分析。[方法]采用连续定点抽样收集病人一般信息,应用NRS2002和SGA对537例2型糖尿病住院病人进行营养筛查或评估,MNA-SF对其中188例老年2型糖尿病住院病人进行营养评估;并进行人体测量和血生化指标检测,分析3种营养评估方法的相关影响因素。[结果]老年2型糖尿病病人与中年2型糖尿病病人比较,身高、总胆固醇(TC)、血红蛋白(HB)均降低(P<0.05),而尿素氮(BUN)、肌酐(Cr)增加明显(P<0.05);男性老年2型糖尿病病人体重、清蛋白(ALB)、总蛋白(TP)、三酰甘油(TG)降低明显(P<0.05),而女性老年2型糖尿病病人小腿围(LC)明显降低(P<0.05)。依据体质指数(BMI)判断标准,2型糖尿病住院病人营养不良、超重及肥胖的构成比分别为3.0%、42.7%、21.4%;根据SGA评估结果,营养不良的病人占9.9%;依据NRS2002,存在营养风险的病人占16.8%;根据MNA-SF评估,存在营养不良的病人占19.7%;Spearman相关分析显示:2型糖尿病住院病人人群中,NRS2002、SGA及MNA-SF评分之间呈正相关(P<0.05);男性和女性2型糖尿病住院病人NRS2002、SGA和MNA-SF均与体重、BMI、腰围(WC)、LC呈正相关(P<0.05)。[结论]2型糖尿病人中超重和肥胖人群比例较高,应用NRS2002、SGA和MNA-SF营养筛查或评估时应结合性别、年龄、人体测量及血生化指标进行综合评估。

Objective: To evaluate the nutritional status quo of inpatients with type 2 diabetes by using NRS2002,SGA and MNA-SF,and to analyze the results. Methods: The general information of patients was collected by continuous fixed-point sampling,and 537 inpatients with type 2 diabetes were evaluated by NRS2002 and SGA.Among them,188 elderly inpatients were assessed by MNA-SF.Human body measurements and blood biochemical indexes were performed to analyze the relevant influencing factors of the three nutrition assessment methods. Results: Compared with middle-aged type 2 diabetes inpatients,the height,TC and HB of elderly type 2 diabetes patients were all decreased( P <0.05), while BUN and Cr were significantly increased( P <0.05).Body weight,ALB,TP and TG decreased significantly in elderly male patients ( P <0.05),while LC decreased significantly in elderly female patients( P <0.05).According to BMI criteria,the proportions of malnutrition,overweight and obesity was 3.0%,42.7% and 21.4% respectively.According to the SGA assessment,the proportion of malnutrition was 9.9%.According to NRS2002,the composition ratio of nutritional risk was 16.8%.According to the MNA-SF assessment,the constituent ratio of malnutrition was 19.7%.Spearman correlation analysis showed that there was a positive correlation between NRS2002,SGA and MNA-SF( P <0.05).NRS2002,SGA and MNA-SF were positively correlated with body weight,BMI,WC and LC in both male and female inpatients with type 2 diabetes( P <0.05). Conclusion: Type 2 diabetes patients had a higher proportion of overweight and obesity,and NRS2002,SGA and MNA-SF should be combined with gender,age,anthropometric measurement and blood biochemical indexes for comprehensive evaluation.