Using four nutritional assessment tools to analyze and compare the risk factors of malnutrition in Type diabetes: A Cross-Sectional Study in Chongqing, China

Abstract

To assess nutritional status of patients with type 2 diabetes and analyze the risk factors by using 4 nutritional assessment tools in The Second Affiliated Hospital of Chongqing Medical University.This study involved 421 patients with type 2 diabetes hospitalized in The Second Affiliated Hospital of Chongqing Medical University between August 2022 and February 2023. Four nutritional assessment tools, including the GLIM, NRS-2002, MUST, and MNA-SF were used to assess nutritional status to the patients with type 2 diabetes. The multivariate logistic regression analysis method was used to identify the risk factors of nutritional status. The 421 patients has 252 (59.9%) males and 169 (40.1%) females, with the mean age of 58 ± 15 years, the median BMI of 24.7±3.8. The incidence of malnutritionnutrition risk were 12.8%, 22.1%, 30.4% and 33.3% for the GLIM, NRS-2002, MUST and MNA-SF tools, respectively. Compared with the well-nourished patients, the malnutrition patients show the significant differences in the aspects of the BMI, Barthel index, education level, sex, smoking, duration of diabetes, complication and medical insurance (P<0.05). After adjusting for confounding factors, the multivariate logistic regression analysis indicated that the BMI (odds ratio (OR) = 0.841, 95% CI = 0.769 - 0.919), sex (OR = 0.539, 95% CI = 0.301 - 0.967 ), duration of diabetes (OR = 0.955, 95% CI = 0.915 - 0.997 ), smoking (OR = 1.996, 95% CI = 1.089 - 3.657 ) might be the independently factors of nutritional status. Excluding the BMI from multivariate logistic regression analyze, the results showed that the Barthel index, education level (OR = 0.53, 95% CI = 0.286 - 0.981), sex (OR = 0.478, 95% CI = 0.272 - 0.843) were independent factors for malnutrition in T2DM patients (all P < 0.05). Excluding BMI again for confounding factor analysis, the multivariate logistic regression analysis indicated that Barthel index, education level (OR = 0.53, 95% CI = 0.286 - 0.981), sex (OR = 0.478, 95% CI = 0.272 - 0.843) were independent factors for malnutrition in T2DM patients (all P < 0.05). We shouldn’t ignore the prevalence of malnutrition in hospitalized patients with type 2 diabetes. The BMI, Sex, Duration of diabetes, smoking, Barthel’s index and Education level were independently associated with malnutrition. We recommend to prevent malnutrition in type 2 diabetes by controlling the influenced factors above.