饮食摄入和营养状况在患有慢性肾脏病 4-5 期的糖尿病和非糖尿病患者中（NutriDiab 研究）。
Dietary Intake and Nutritional Status in Diabetic and Nondiabetic Patients With Chronic Kidney Disease Stage 4-5 (NutriDiab Study).
机构信息
Department of Medical Clinic, Botucatu Medical School, Universidade Estadual Paulista-UNESP, Botucatu, Brazil.
Department of Nephrology, Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, Pierre-Bénite, France.
出版信息
J Ren Nutr. 2024 Jan;34(1):19-25. doi: 10.1053/j.jrn.2023.06.006. Epub 2023 Jun 13.
OBJECTIVES
The aim of the present study was to assess the dietary intake and nutritional status of patients with chronic kidney disease (CKD) stage 4-5 according to the presence of diabetes.
METHODS
This observational and cross-sectional study included adult patients with CKD stage 4-5 referred to a nephrology unit, between October 2018 and March 2019. Daily dietary intake was evaluated by 24-hour dietary inquiry and urine excretion. Nutritional status was assessed by measuring body composition using bioimpedance analysis and muscle function using handgrip strength. Undernutrition was considered using the protein energy wasting score.
RESULTS
A total of 75 CKD patients were included, 36 (48%) of whom had diabetes; median age (interquartile range) was 71 (60-80) years. The median weight-adjusted dietary energy intake (DEI) was 22.6 (19.1-28.2) kcal/kg/day and the mean weight-adjusted dietary protein intake (DPI) was 0.86 ± 0.19 g/kg/day. There was no significant difference in DEI and DPI between patients with diabetes and those without, except for weight-adjusted DPI which was significantly lower in diabetic patients (P = .022). In univariate analysis, diabetes was associated with weight-adjusted DPI (coefficient [95% confidence interval] -0.237 [-0.446; -0.004] kcal/kg/day; P = .040), but this association did not remain significant in multivariate analysis. Nutritional status did not differ significantly between diabetic and nondiabetic patients except for lean tissue mass, which was lower in diabetic patients (P = .046). The proportion of patients with protein energy wasting was not significantly different between diabetic and nondiabetic patients (13.9% vs. 10.2%, respectively).
CONCLUSIONS
In the present cohort, DPI and DEI were not significantly different between diabetic and nondiabetic CKD patients. Diabetes was not found to be associated with dietary intakes in CKD stage 4-5 patients.
目的
本研究旨在评估根据糖尿病的存在，慢性肾脏病（CKD）4-5 期患者的饮食摄入和营养状况。
方法
本观察性和横断面研究纳入了 2018 年 10 月至 2019 年 3 月期间被转诊至肾病科的 CKD 4-5 期成年患者。通过 24 小时饮食询问和尿液排泄来评估每日饮食摄入。使用生物阻抗分析测量身体成分来评估营养状况，并使用握力来评估肌肉功能。使用蛋白质能量消耗评分来评估营养不良。
结果
共纳入 75 例 CKD 患者，其中 36 例（48%）患有糖尿病；中位年龄（四分位间距）为 71（60-80）岁。中位体重校正膳食能量摄入（DEI）为 22.6（19.1-28.2）kcal/kg/天，平均体重校正膳食蛋白摄入（DPI）为 0.86±0.19g/kg/天。糖尿病患者与非糖尿病患者的 DEI 和 DPI 无显著差异，除了糖尿病患者的体重校正 DPI 显著较低（P=0.022）。在单变量分析中，糖尿病与体重校正 DPI 相关（系数[-0.446；-0.004]kcal/kg/天；P=0.040），但在多变量分析中这种关联不再显著。除了瘦组织量，糖尿病患者的瘦组织量较低（P=0.046），其他营养状况在糖尿病患者和非糖尿病患者之间无显著差异。患有蛋白质能量消耗的患者比例在糖尿病患者和非糖尿病患者之间无显著差异（分别为 13.9%和 10.2%）。
结论
在本队列中，糖尿病和非糖尿病 CKD 患者的 DPI 和 DEI 无显著差异。在 CKD 4-5 期患者中，糖尿病与饮食摄入无关。
Zotero 插件