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糖尿病肾病患者营养状况及蛋白质能量消耗的测定

Determination of nutritional status and protein-energy wasting in patients with diabetic nephropathy.

作者信息

Karakas Elif, Colak Hatice, Gunes Fatma Esra, Karakoyun Berna

机构信息

Department of Nutrition and Dietetics, Marmara University Institute of Health Sciences, Istanbul, Turkiye.

Department of Nutrition and Dietetics, Uskudar University Faculty of Health Sciences, Istanbul, Turkiye.

出版信息

North Clin Istanb. 2024 Nov 19;11(6):560-568. doi: 10.14744/nci.2023.66503. eCollection 2024.

Abstract

OBJECTIVE

This study aims to evaluate the nutritional status of patients with stage 3 and 4 diabetic nephropathy (DN; DN-3 and DN-4) and to explain the effect of DN stages on the prognosis of protein-energy wasting (PEW).

METHODS

Data from demographic characteristics, anthropometric measurements, biochemical findings, food consumption records, and the Subjective Global Assessment (SGA) screening tool of 49 patients (25 DN-3; 24 DN-4) who were followed at the nephrology department were collected. The criteria of the International Society of Renal Nutrition and Metabolism (ISRNM) were used to determine PEW.

RESULTS

56% of DN-3 and 66.7% of DN-4 have been diagnosed with diabetes for over 15 years. The groups differed in total body weight, body-muscle weight, creatinine, microalbuminuria, and eGFR values (p<0.05). Protein (g/kg) intake was only different between the groups (p<0.05). 18.4% of patients had SGA-B score, and 26.5% had PEW.

CONCLUSION

Our study provides a general impression about the presence of PEW in DN patients not receiving dialysis in Turkiye. In patients with DN-3 and DN-4, daily energy and macronutrient intakes are adequate by recommendation. According to ISRNM criteria, the prevalence of PEW increased with advancing disease stage. PEW was observed to be more effective than SGA in assessing malnutrition.

摘要

目的

本研究旨在评估3期和4期糖尿病肾病(DN;DN-3和DN-4)患者的营养状况,并解释DN分期对蛋白质能量消耗(PEW)预后的影响。

方法

收集了肾脏病科随访的49例患者(25例DN-3;24例DN-4)的人口统计学特征、人体测量数据、生化检查结果、食物消费记录以及主观全面评定(SGA)筛查工具的数据。采用国际肾脏营养与代谢学会(ISRNM)的标准来确定PEW。

结果

56%的DN-3患者和66.7%的DN-4患者已确诊糖尿病超过15年。两组在总体重、肌肉重量、肌酐、微量白蛋白尿和估算肾小球滤过率(eGFR)值方面存在差异(p<0.05)。蛋白质摄入量(g/kg)在两组之间也存在差异(p<0.05)。18.4%的患者SGA评分为B级,26.5%的患者存在PEW。

结论

我们的研究对土耳其未接受透析的DN患者中PEW的存在情况给出了总体印象。对于DN-3和DN-4患者,按推荐每日能量和常量营养素摄入量是充足的。根据ISRNM标准,PEW的患病率随着疾病阶段的进展而增加。观察发现,PEW在评估营养不良方面比SGA更有效。

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Diabetic nephropathy: A twisted thread to unravel.糖尿病肾病:一条亟待解开的扭曲之线。
Life Sci. 2021 Aug 1;278:119635. doi: 10.1016/j.lfs.2021.119635. Epub 2021 May 17.

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