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2型糖尿病患者控制营养状况评分与全因死亡率及癌症死亡风险的关联:1999 - 2018年美国国家健康与营养检查调查(NHANES)

Association of the controlling nutritional status score with all-cause mortality and cancer mortality risk in patients with type 2 diabetes: NHANES 1999-2018.

作者信息

Pan Dikang, Guo Julong, Su Zhixiang, Wang Jingyu, Wu Sensen, Guo Jianming, Gu Yongquan

机构信息

Xuanwu Hospital, Capital Medical University, Beijing, China.

Renal Division, Peking University First Hospital, Beijing, China.

出版信息

Diabetol Metab Syndr. 2023 Aug 21;15(1):175. doi: 10.1186/s13098-023-01138-2.

Abstract

OBJECTIVE

There are studies on the nutritional status of type 2 diabetes (T2D), but there are no large cohort studies on the prognosis of Controlling Nutritional Status (CONUT) score for T2D. The aim of this study was to examine the association between CONUT score and all-cause mortality as well as cancer mortality in adults with T2D.

METHODS

For this study, we analyzed a total of 3763 adult patients with T2D who were part of the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018. Mortality outcomes were determined by linking to the National Death Index records as of December 31, 2019. Cox proportional risk models were used to estimate risk ratios (HRs) and 95% confidence intervals (CIs) for all-cause and cancer deaths.

RESULTS

During the mean follow-up of 8.17 years, there were 823 deaths from all causes and 155 deaths from cancer. After adjusting for multiple variables, the risk of all-cause mortality was higher in patients with a Mild (CONUT score ≥ 2), compared with patients with a Normal (CONUT score of 0-1). All-cause mortality risk was 39% higher, and cancer mortality risk was 45% higher. Consistent results were observed when stratified by age, sex, race, BMI, smoking status, and glycated hemoglobin levels.

CONCLUSIONS

In a nationally representative sample of American adults with T2D, we found an association between CONUT score and all-cause mortality and cancer mortality.

摘要

目的

有关于2型糖尿病(T2D)营养状况的研究,但尚无关于T2D控制营养状况(CONUT)评分预后的大型队列研究。本研究的目的是探讨CONUT评分与T2D成年患者全因死亡率以及癌症死亡率之间的关联。

方法

在本研究中,我们分析了1999年至2018年美国国家健康与营养检查调查(NHANES)中的3763例成年T2D患者。通过与截至2019年12月31日的国家死亡指数记录相链接来确定死亡结局。采用Cox比例风险模型估计全因死亡和癌症死亡的风险比(HR)及95%置信区间(CI)。

结果

在平均8.17年的随访期间,共有823例全因死亡和155例癌症死亡。在对多个变量进行调整后,与营养状况正常(CONUT评分为0 - 1)的患者相比,营养状况轻度不良(CONUT评分≥2)的患者全因死亡风险更高。全因死亡风险高39%,癌症死亡风险高45%。按年龄、性别、种族、体重指数、吸烟状况和糖化血红蛋白水平分层时观察到了一致的结果。

结论

在具有全国代表性的美国成年T2D患者样本中,我们发现CONUT评分与全因死亡率和癌症死亡率之间存在关联。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8ab/10440932/8a0de01dfc2c/13098_2023_1138_Fig1_HTML.jpg

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