社区居住的老年糖尿病患者的营养状态评估

Nutritional status among the community-dwelling elderly with diabetes mellitus

摘要:

目的 本研究拟探索社区居住的老年糖尿病患者的营养状况,并与非糖尿病老年人进行比较。方法 纳入2013年至2014年在北京香河园社区居住的老年人820名为研究对象,依据是否患糖尿病分为2组:糖尿病组(n＝170)和非糖尿病组(n＝650)。该研究由接受过问卷调查培训并通过考核的研究助理在社区卫生服务中心或入户对老年人进行面对面访视。应用老年医学疾病累积评分量表(CIRS-G)进行慢病评分。应用微营养评估简表(MNA-SF)进行营养评估。依据体质量指数(BMI)不同,将糖尿病组患者分为5个亚组,与MNA-SF的营养评估结果进行χ²分析。采用SPSS 20.0软件进行数据处理。结果 820名研究对象年龄65～97(75.4±6.7)岁,患病数(4.7±3.3)种,其中727名(88.7%)老年人可生活自理,其余可半自理。糖尿病组的CIRS-G评分显著高于非糖尿病组[(6.38±3.67) vs(4.28±3.09)分,P<0.001]。糖尿病组和非糖尿病组营养不良(5.9% vs 6.3%)和营养不良风险(48.2% vs 45.8%)的发生率差异均无统计学意义(P＞0.05)。糖尿病组超重(38.2% vs 34.5%)和肥胖(19.4% vs 13.8%)的发生率均显著高于非糖尿病组(P<0.05)。各糖尿病亚组患者营养状态与BMI水平差异无统计学意义(χ²=10.394,P=0.238)。结论 社区糖尿病老年人的营养不良发生率与非糖尿病的老年人无明显不同,约半数糖尿病老年人存在营养不良风险。糖尿病患者营养状态与BMI水平无明显相关性。

Abstract:

Objective To explore the nutritional status among the community-dwelling elderly patients with diabetes mellitus (DM) and compare the differences with those without DM. Methods A cross-sectional survey was conducted in the 820 elderly residents in Xiangheyuan Community, Beijing, through face-to-face interviews by qualified research assistants during 2013 and 2014, and they were divided into DM group (n=170) and non-DM group (n=650). Cumulative illness rating scale for geriatrics (CIRS-G) and mini-nutritional assessment short form (MNA-SF) were used to evaluate their chronic disease and nutritional status. The DM group was further assigned into 5 subgroups based on the body mass index (BMI), and their nutritional statuses were compared with Chi-square test. SPSS statistics 20.0 was used to perform the statistical analysis. Results The 820 elderly subjects were at age of (75.4±6.7) years (ranging from 65 to 97 years), and had (4.7±3.3) types of comorbidities. There were 727(88.7%) subjects living on their own, and the others were partially dependent. The CIRS-G score was significantly higher in the DM group than the non-DM group [(6.38±3.67) vs (4.28±3.09), P<0.001]. There were no obvious differences in the incidence rates of malnutrition (5.9% vs 6.3%) and malnutrition risk (48.2% vs 45.8%) between the 2 groups (P>0.05). The DM group also had higher prevalence of overweight (38.2% vs 34.5%) and obesity (19.4% vs 13.8%) when compared with the non-DM group (P<0.05). No statistic difference was seen in the nutritional status among the DM patients with different BMI (Chi-square=10.394, P=0.238). Conclusion The prevalence of malnutrition is similar among the community-dwelling elderly with or without DM. Nearly half of the DM elderly residents are at the risk of malnutrition. There is no association of nutritional status and BMI level in the DM elderly.