Department of Internal Medicine, Otsu City Hospital, Shiga, Japan.
Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Endocr J. 2019 Dec 25;66(12):1073-1082. doi: 10.1507/endocrj.EJ19-0107. Epub 2019 Aug 21.
Diabetes and malnutrition sometimes overlap. Little is known about the relationship between malnutrition and subclinical atherosclerosis in patients with type 2 diabetes. This cross-sectional study investigated this relationship in patients with type 2 diabetes. We evaluated the relationships between malnutrition assessed by controlling nutritional status (CONUT) score and subclinical atherosclerosis assessed by carotid intima-media thickness (IMT) and carotid plaque scores in 461 consecutive patients with type 2 diabetes. Nutritional assessment indicated that 38% of patients were malnourished (CONUT ≥3). Carotid IMT and carotid plaque scores were significantly higher in patients with malnutrition. Multivariate linear regression analyses revealed that a high CONUT score (CONUT ≥3) was correlated with mean IMT (β = 0.196, p = 0.043) and max IMT (β = 0.243, p = 0.011) in patients taking statins and was also correlated with mean IMT (β = 0.287, p = 0.004), max IMT (β = 0.308, p = 0.002), and plaque score (β = 0.190, p = 0.044) in patients not taking statins after adjusting for age, sex, duration of diabetes, body mass index, hemoglobin A1c, creatine, smoking, and hypertension. Our results demonstrate a relationship between malnutrition and subclinical atherosclerosis in patients with type 2 diabetes.
糖尿病和营养不良有时会重叠。人们对 2 型糖尿病患者营养不良与亚临床动脉粥样硬化之间的关系知之甚少。本横断面研究调查了 2 型糖尿病患者中这种关系。我们评估了 461 例连续 2 型糖尿病患者的控制营养状况(CONUT)评分评估的营养不良与颈动脉内膜中层厚度(IMT)和颈动脉斑块评分评估的亚临床动脉粥样硬化之间的关系。营养评估表明,38%的患者存在营养不良(CONUT≥3)。营养不良患者的颈动脉 IMT 和颈动脉斑块评分明显更高。多变量线性回归分析显示,高 CONUT 评分(CONUT≥3)与服用他汀类药物的患者的平均 IMT(β=0.196,p=0.043)和最大 IMT(β=0.243,p=0.011)相关,与未服用他汀类药物的患者的平均 IMT(β=0.287,p=0.004)、最大 IMT(β=0.308,p=0.002)和斑块评分(β=0.190,p=0.044)相关,调整年龄、性别、糖尿病病程、体重指数、糖化血红蛋白、肌酐、吸烟和高血压后。我们的结果表明,2 型糖尿病患者的营养不良与亚临床动脉粥样硬化之间存在关系。