老年2型糖尿病患者存在营养不良风险现状及危险因素分析

Risk Status and Risk Factors of Malnutrition in Elderly Patients with Type 2 Diabetes Mellitus

摘要: 目的：对老年2型糖尿病患者进行营养风险筛查，了解其存在营养不良风险情况，并分析老年2型糖尿病患者存在营养不良风险的危险因素。方法：本研究采用随机抽样法选取2024年1月至2024年11月在吴起县人民医院住院部就诊的患者，并通过转诊于乡镇卫生院管理的老年2型糖尿病患者。采用一般资料调查表、营养风险筛查评估表(NRS-2002)、Zung焦虑、抑郁自评量表(SAS、SDS)收集相关资料。采用SPSS 26.0软件统计分析，计数资料组间比较采用χ²检验；计量资料符合正态分布组间比较采用t检验；以患者是否发生营养不良风险为因变量，将单因素分析中有统计学意义的变量纳入二元Logistic回归进行分析老年2型糖尿病患者营养不良风险的危险因素，以P < 0.05为差异具有统计学意义。结果：本研究共纳入300例老年2型糖尿病患者，平均年龄为(66.97 ± 5.45)岁，其中存在营养不良风险的为65例(NRS-2002 ≥ 3分)，营养不良风险的发生率为21.67%。其中存在营养不良风险组的老年T2DM患者NRS-2002总分平均分为(3.45 ± 0.69)分。NRS-2002得分为3分的有43例，占(43/65) 66.15%，排序第一，NRS-2002得分为4分的有15例，占(15/65) 23.08%，NRS-2002得分为5分的有7例，占(7/65) 10.77%。二元Logistic回归分析结果显示，年龄(OR = 4.63)、抑郁(OR = 2.75)、白蛋白(OR = 2.25)、合并周围血管病变(OR = 3.13) 4个变量进入方程。结论：年龄、血清白蛋白、抑郁和合并周围血管病变是老年2型糖尿病患者存在营养不良风险独立危险因素。因此，对于老年2型糖尿病患者来说，除了积极控制血糖外，在临床中应特别关注其营养状况，还需要注意饮食合理、营养均衡，以降低营养不良和血管病变的风险，对于已经发生血管病变的患者，应积极配合医生进行治疗和康复，以减轻症状，同时应充分考虑患者的心理状态，提供必要的心理支持和干预。

Abstract: Objective: To conduct nutritional risk screening in elderly patients with type 2 diabetes, to understand the risk of malnutrition, and to analyze the risk factors of malnutrition in elderly patients with type 2 diabetes. Methods: In this study, a random sampling method was used to select the patients who were admitted to the Inpatient Department of Wuqi County People’s Hospital from January to November 2024, and the elderly patients with type 2 diabetes were referred to township health centers. The relevant data were collected by general data questionnaire, Nutrition Risk Screening Assessment Form (NRS-2002) and Zung Self-rating Scale for Anxiety and Depression (SAS and SDS). SPSS 26.0 software was used for statistical analysis, and comparison among data groups was conducted by χ² test. Measurement data conforming to normal distribution were compared between groups using t test. With the risk of malnutrition as the dependent variable, variables with statistical significance in univariate analysis were incorporated into binary Logistic regression to analyze the risk factors of malnutrition in elderly patients with type 2 diabetes, and P < 0.05 was considered statistically significant. Results: A total of 300 elderly patients with type 2 diabetes mellitus were included in this study, with an average age of (66.97 ± 5.45) years, of which 65 were at risk of malnutrition (RS2002 ≥ 3 points), and the incidence of malnutrition risk was 21.67%. Among the elderly T2DM patients with malnutrition risk group, the mean total score of NRS-2002 was (3.45 ± 0.69). There were 43 cases, accounting for 66.15% (43/65), of whom the score of NRS-2002 was 3, ranking first, 15 cases, accounting for 23.08% (15/65), and 7 cases, accounting for 10.77% (7/65), of which the score of NRS-2002 was 4. Binary Logistic regression analysis showed that age (OR = 4.63), depression (OR = 2.75), albumin (OR = 2.25) and peripheral vascular disease (OR = 3.13) were included in the equation. Conclusion: Age, serum albumin, depression and peripheral vascular disease are independent risk factors for malnutrition in elderly patients with type 2 diabetes. Therefore, in addition to actively controlling blood sugar, elderly patients with type 2 diabetes should pay special attention to their nutritional status in clinic, and pay attention to reasonable diet and balanced nutrition to reduce the risk of malnutrition and vascular disease. For patients with vascular disease, they should actively cooperate with doctors for treatment and rehabilitation to reduce symptoms. At the same time, the psychological state of patients should be fully considered to provide necessary psychological support and intervention.