老年2型糖尿病患者营养不良的影响因素分析

Factors affecting malnutrition among elderly patients with type 2 diabetes mellitus

林芳 ¹刘素贞 ¹江海燕¹

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作者信息

1. 浙江大学医学院附属杭州市第一人民医院全科医学科,浙江杭州 310006
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摘要

目的了解老年2型糖尿病(T2DM)患者营养不良的影响因素,为预防老年T2DM患者营养不良提供参考.方法选择2022年6月-2023年6月浙江大学医学院附属杭州市第一人民医院全科医学科就诊的≥60岁T2DM患者为调查对象,通过问卷调查收集人口学信息、服药和合并症等资料,通过病例系统收集糖化血红蛋白(HbA1c)、白蛋白(ALB)和血红蛋白(Hb)等血生化指标,采用新版微型营养评估简表评估营养状况,采用多因素logistic回归模型分析营养不良的影响因素.结果调查老年T2DM患者382例,其中男性226例,占59.16％;女性156例,占40.84％.年龄为(70.06±8.41)岁.检出营养不良85例,检出率为22.25％.多因素logistic回归分析结果显示,年龄(70～＜80 岁,OR=1.261,95％CI:1.007～1.158;≥80 岁,OR=3.285,95％CI:1.618～6.662)、合并症 ≥3 种(OR=2.790,95％CI:1.254～5.191)、多重用药(OR=3.501,95％CI:1.841～6.658)、睡眠障碍(OR=1.613,95％CI:1.120～2.322)、规律运动(OR=0.280,95％CI:0.115～0.614)、ALB≥35 g/L(OR=0.272,95％CI:0.102～0.560)和HbA1c≥7％(OR=2.914,95％CI:1.445～5.881)是老年T2DM患者营养不良的影响因素.结论老年T2DM患者营养不良与年龄、合并症数量、多重用药、睡眠障碍、规律运动、HbA1c和ALB水平有关,需定期开展营养筛查,加强健康教育.

Abstract

Objective To investigate the factors affecting the development of malnutrition among the elderly patients with type 2 diabetes mellitus(T2DM),so as to provide insights into the prevention of malnutrition among the elderly pa-tients with T2DM.Methods Elderly T2DM patients at ages of 60 years and older admitted to Hangzhou First People's Hospital affiliated to Zhejiang University School of Medicine from June 2022 to June 2023 were recruited.Patients'de-mographics,number of medicines administered and comorbidities were collected using questionnaire surveys,and glycosyl-ated hemoglobin(HbA1c),serum albumin(ALB)and hemoglobin levels were collected from medical records.The nutri-tion status was assessed with the new version of the Mini Nutritional Assessment Short Form(MNA-SF).Factors affect-ing the development of malnutrition were among the elderly T2DM patients identified using a multivariable logistic re-gression model.Results A total of 382 elderly T2DM patients were enrolled,including 226 men(59.16％)and 156 women(40.84％)and with a mean age of(70.06±8.41)years.The prevalence of malnutrition was 22.25％among partici-pants.Multivariable logistic regression analysis identified age(70 to 79 years,OR=1.261,95％CI:1.007-1.158;80 years and older,OR=3.285,95％CI:1.618-6.662),three and more types of comorbidities(OR=2.790,95％CI:1.254-5.191),use of multiple medicines(OR=3.501,95％CI:1.841-6.658),sleep disorders(OR=1.613,95％CI:1.120-2.322),regular exercises(OR=0.280,95％CI:0.115-0.614),serum ALB of 35 g/L and greater(OR=0.272,95％CI:0.102-0.560)and HbA1c of 7％and higher(OR=2.914,95％CI:1.445-5.881)as factors affecting the development of malnutrition among elderly patients with T2DM.Conclusions The risk of malnutrition is associated with age,types of comorbidities,use of multiple medicines,sleep disorders,regular exercise,HbA1c and ALB among the elderly patients with T2DM.Period-ical nutrition screening and intensified health education are recommended for T2DM patients.

关键词

2型糖尿病/老年/营养不良/影响因素

Key words

type 2 diabetes mellitus/elderly/malnutrition/influencing factor

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基金项目

杭州市医药卫生科技计划项目(A20200702)

出版年

2024

预防医学

浙江省预防医学会

预防医学

CSTPCD

影响因子：1.002

ISSN：2096-5087

参考文献量20

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