摘要
目的:探讨糖化血红蛋白(HbA1c)水平对老年2型糖尿病肾病患者营养状况的影响。方法:收集我院2019年1月—2022年6月收治的90例老年糖尿病肾病患者的临床资料。根据患者NRS2002评分将患者分为对照组(NRS2002<3分,34例)和观察组(NRS2002≥3分,56例)。比较2组患者的一般情况和实验室指标,分析HbA1c水平对老年尿病肾病患者营养状况的影响,以及老年糖尿病肾病患者营养不良的危险因素。结果:老年糖尿病肾病患者营养状况不佳发生率为62.22%,NRS2002≥3分组患者体质指数(BMI)值更低,营养知识、营养态度、营养行为评分更低,且接受透析治疗的患者营养状况不佳率更高,均有P<0.05。NRS2002≥3分组的老年糖尿病肾病患者血尿素氮(BUN)、HbA1c显著高于NRS2002<3分组(P<0.05),血清白蛋白(ALB)及肾小球滤过率(eGFR)水平显著低于NRS2002<3分组(P<0.05),2组患者血脂水平(甘油三酯、总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇)无差异(P>0.05)。老年糖尿病肾病患者BMI值低、营养行为得分低、eGFR和ALB水平低,以及HbA1c水平高是营养状况不佳的危险因素。结论:老年糖尿病肾病患者营养状况不佳发生率较高,HbA1c水平高的老年糖尿病肾病患者的营养状况更差,且低BMI、不良营养行为、eGFR和ALB水平低是影响老年糖尿病肾病患者营养状况的独立危险因素。临床上应关注老年糖尿病肾病患者营养状况,以改善患者预后,提高生活质量。
【Objective】 To investigate the effect of glycosylated hemoglobin(HbA1c) levels on the nutritional status of elderly patients with type 2 diabetic nephropathy. 【Method】 The clinical data of 90 elderly patients with diabetic nephropathy admitted to our hospital from January 2019 to June 2022 were collected. Patients were divided into control group(NRS2002<3 points, 34 cases) and observation group(NRS2002≥3 points, 56 cases) according to their NRS2002 scores. The general conditions and laboratory indexes of the two groups were compared, and the influence of HbA1c level on the nutritional status of elderly patients with uropathy nephropathy and the risk factors of malnutrition in elderly patients with diabetic nephropathy were analyzed.【Result】 The prevalence of poor nutritional status in elderly diabetic nephropathy patients was 62.22%,and patients in the NRS2002≥3 subgroup had lower BMI,lower nutritional knowledge, nutritional attitude, and nutritional behavior scores, and higher rates of poor nutritional status in patients treated with dialysis, all with P<0.05. Serum BUN and HbA1c were significantly higher in elderly diabetic nephropathy patients in the NRS2002≥3 subgroup than in the NRS 2002<3 subgroup(P<0.05),serum ALB and eGFR levels were significantly lower than those of NRS2002<3 subgroup(P<0.05),and there was no difference in lipid levels(TC,TG,LDL-C,HDL-C) between the two groups(P>0.05). Low BMI,low nutritional behavior scores, low eGFR and ALB levels, and high HbA1c levels in elderly patients with diabetic nephropathy were risk factors for poor nutritional status. 【Conclusion】 The incidence of poor nutritional status is higher in elderly diabetic nephropathy patients, and the nutritional status of elderly diabetic nephropathy patients with high HbA1c levels is worse, and low BMI,poor nutritional behavior, low eGFR and ALB levels are independent risk factors affecting the nutritional status of elderly diabetic nephropathy patients. Clinical attention should be paid to the nutritional status of elderly patients with diabetic nephropathy in order to improve their prognosis and quality of life.
作者
陈艳
王萍
CHEN Yan;WANG Ping(Endocrine Department,Nanjing Gaochun Peoples Hospital,Nanjing 211302,China)
出处
《中国食物与营养》
2023年第1期81-83,88,共4页
Food and Nutrition in China
