2型糖尿病合并慢性并发症住院患者的营养风险状况调查

Investigation on nutritional risk for inpatients with type 2 diabetes mellitus complicated with chronic complications

目的 了解2型糖尿病(T2DM)合并慢性并发症住院患者的营养风险状况。方法 采用营养风险筛查2002(NRS2002)量表对603例T2DM合并慢性并发症(糖尿病大血管病变、糖尿病周围神经病变、糖尿病视网膜病变、糖尿病肾病、糖尿病足)住院患者进行营养风险筛查,根据评分结果将患者分为有营养风险组和无营养风险组,比较两组体质指数,血红蛋白、血清前白蛋白、血清白蛋白、HbA1c水平,以及住院天数、住院费用。分析患者发生营养风险的危险因素,以及住院时间、住院费用与患者发生营养风险的相关性。结果 603例T2DM合并慢性并发症住院患者的营养风险发生率为25.04%(151/603)。有营养风险组的年龄、HbA1c水平均高于无营养风险组,体质指数及血红蛋白、血清白蛋白、血清前白蛋白水平均低于无营养风险组(均P<0.05)。多因素Logistic回归分析结果显示,年龄和HbA1c水平是T2DM合并慢性并发症住院患者发生营养风险的危险因素,体质指数和血清白蛋白水平是其保护因素(均P<0.05)。Spearman相关性分析显示,住院时间、住院费用与T2DM合并慢性并发症住院患者发生营养风险相关(均P<0.05)。结论 T2DM合并慢性并发症住院患者存在一定的营养风险。年龄较大和HbA1c水平升高的T2DM合并慢性并发症住院患者发生营养风险增加,体质指数和血清白蛋白水平升高者发生营养风险降低。

Objective To understand nutritional risk for inpatients with type 2 diabetes mellitus(T2 DM) complicated with chronic complications.Methods The Nutritional Risk Screening 2002(NRS2002) scale was employed to screen nutritional risk for 603 T2 DM inpatients complicated with chronic complications(diabetic macroangiopathy, diabetic peripheral neuropathy, diabetic retinopathy, diabetic nephropathy, and diabetic foot). The patients were assigned to nutritional risk group and non-nutritional risk group according to the score results. The body mass index, and the levels of hemoglobin, serum prealbumin, serum albumin, HbA1 c, as well as length and cost of hospital stay were compared between the two groups. The risk factors for patients suffering from nutritional risk, and the correlation of length and cost of hospital stay with the occurrence of nutritional risk in patients were analyzed. Results The incidence rate of nutritional risk in 603 T2 DM inpatients complicated with chronic complications was 25.04%(151/603). The nutritional risk group exhibited older age, and a higher level of HbA1 c, whereas lower body mass index, and lower levels of hemoglobin, serum albumin, serum prealbumin as compared with the non-nutritional risk group(all P<0.05). The results of multivariate Logistic regression analysis revealed that age and HbA1 c level were the risk factors for the occurrence of nutritional risk in T2 DM inpatients complicated with chronic complications, while body mass index and serum albumin level were the protective factors(all P<0.05). The Spearman correlation analysis interpreted that length and cost of hospital stay correlated with the occurrence of nutritional risk in T2 DM inpatients complicated with chronic complications(all P<0.05). Conclusion The T2 DM inpatients complicated with chronic complications have nutritional risk in a certain extent. The T2 DM inpatients with concomitant chronic complications in older age and with increase of HbA1 c level are at a increased risk for the occurrence of nutritional risk, whereas the patients with increases of body mass index and albumin level are at a decreased risk for the occurrence of nutritional risk.