老年糖尿病患者营养不良患病率的Meta分析

Prevalence of malnutrition in elderly patients with type 2 diabetes mellitus:a meta-analysis

目的系统评价老年糖尿病患者营养不良的患病率。方法系统检索PubMed、Embase、Web of Science、The Cochrane Library、中国生物医学文献数据库、中国知网、维普数据库和万方数据库,自建库至2023年9月13日的老年糖尿病患者营养不良现状的横断面研究,根据不同文献中营养评估工具定义营养不良。由2名研究者独立进行文献筛选、资料提取以及质量评价,应用Stata 16.0软件进行数据分析。结果共纳入22篇文献,涉及6349例老年糖尿病患者。Meta分析结果显示,老年糖尿病患者营养不良的总体患病率为32%(95%CI 0.21~0.43),有营养不良风险的患病率为49%(95%CI 0.31~0.67)。亚组分析结果显示,伴有慢性并发症的老年糖尿病患者营养不良的患病率高于不伴有慢性并发症的患者(56.8%比21.9%);住院患者营养不良的患病率(44.4%)高于门诊(29.0%)和社区(18.5%);采用微型营养评定量表评估营养不良时,患病率高于微型营养评定简表量表(35.8%比23.3%),差异有统计学意义(P<0.05)。不同性别老年糖尿病患者的营养不良患病率比较,差异无统计学意义(P>0.05)。结论老年糖尿病患者营养不良和有营养不良风险的患病率均较高。临床医务人员不仅要加强对患者营养不良的早期识别,更要重视对有营养不良风险的筛查,尽早采取合理的干预措施,加强对患者的营养健康教育以改善老年糖尿病患者预后,提高患者的生活质量。

ObjectiveTo systematically evaluate the prevalence of malnutrition in elderly patients with diabetes.MethodsA total of eight databases,namely PubMed,Embase,Web of Science,The Cochrane Library,China National Knowledge Infrastructure(CNKI),Wanfang Database,Chinese Biomedical Literature Database(CBM),and VIP Database,were systematically searched for cross-sectional studies on malnutrition in elderly diabetic patients published from the inception of the databases to September 13,2023.Two researchers independently conducted literature screening,data extraction,and quality assessment.Data analysis was performed using Stata 16.0 software.ResultsA total of 22 studies were included,involving 6349 elderly diabetic patients.Results of the meta-analysis showed that the overall prevalence of malnutrition in elderly patients with diabetes was 32.3%(95%CI:0.21 to 0.43),and the prevalence of at-risk of malnutrition was 49.0%(95%CI:0.31 to 0.67).Subgroup analysis showed that the prevalence of malnutrition in elderly diabetic patients with chronic complications(56.8%)was significantly higher than those without chronic complications(21.9%).Inpatients also showed a higher prevalence compared with outpatients and community(44.4%,29.0%,and 18.5%,respectively).The prevalence of malnutrition as per mini-nutritional assessment scale was higher than that as per mini-nutritional assessment short-form scale(35.8%vs.23.3%,P<0.05).There was no significant difference in the prevalence of malnutrition in elderly diabetic patients of different genders(P>0.05).ConclusionsThe prevalence of malnutrition and at-risk of malnutrition in elderly diabetic patients is high.In clinical practice,we should not only strengthen the early diagnosis of malnutrition in patients,but also emphasize the screening of malnutrition risk,implement timely corresponding interventions,and promote patient education on nutrition and health,to improve the prognosis and quality of life in elderly diabetes patients.