Liu Yan, Song Chunhua, Wang Xue, Ma Xianghua, Zhang Pianhong, Chen Gaiyun, Cheng Zhenqian, Liu Juying, Yao Ying, Ma Wenjun, Li Zengning, Sun Ping, Lin Fan, Hou Weilian, Han Ting, Zhang Ying, Weng Min, Shi Wanying, Yang Dagang, Feng Ji, Chen Junqiang, Li Li, Jiang Hua, Xu Hongxia, Guo Ruifang, Liu Ying, Chen Xiaopan, Zhao Qian, Qi Yumei, Chi Qiang, Liu Rong, Xiong Rui, Wu Tiantian, Tang Shangfeng, Guo Shuyan, Chen Wei
Department of Clinical Nutrition, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.
Department of Epidemiology and Statistics, College of Public Health, Zhengzhou University, Zhengzhou, 450001, China.
Sci China Life Sci. 2025 May;68(5):1487-1497. doi: 10.1007/s11427-023-2619-7. Epub 2025 Jan 21.
Malnutrition substantially contributes to adverse clinical outcomes. However, no national survey has been conducted to characterize its epidemiology in hospital settings in China. We conducted the China Nutrition Fundamental Data 2020 project among a multistage stratified cluster sample of adult inpatients from 291 study sites across 30 provinces, autonomous regions and municipalities (except for Hong Kong, Macao, Taiwan Province, and the Xizang Autonomous Region, please see MATERIALS AND METHODS for details of the causes) of China to generate reliable data on the prevalence of malnutrition and explore the associated risk factors. We collected information on participants' sociodemographic characteristics, physical examinations, and laboratory test results. Malnutrition was defined according to the Global Leadership Initiative on Malnutrition (GLIM) criteria. The standardized prevalence of malnutrition was calculated, and factors associated with malnutrition were examined using logistic regression analyses. We included 54,652 individuals with seven systemic diseases who completed all the survey documents in the final analysis. The overall prevalence of malnutrition was 12.5%, representing 7.6 million adult inpatients in China. The prevalence of malnutrition was higher in men, individuals aged ⩾ 60 years, residents of central and western regions, people from lower economic areas, and those with lower education levels than in women, individuals aged <60 years, residents of eastern regions, individuals from higher economic areas, and those with higher education levels. Patients with higher disease severity scores, infectious diseases, and neoplasms had a higher tendency for malnutrition than those without such conditions. Sex, age, region, economic level, education level, disease severity score, infectious diseases, and neoplasms were independently associated with malnutrition. In conclusion, malnutrition is prevalent among Chinese adult inpatients, necessitating national- and hospital-level interventions. This survey provides several avenues to begin addressing the burden of malnutrition in China.
营养不良是导致不良临床结局的重要因素。然而，中国尚未开展全国性调查以描述医院环境中营养不良的流行病学特征。我们在中国30个省、自治区和直辖市（不包括香港、澳门、台湾地区以及西藏自治区，具体原因详见材料与方法）的291个研究地点，对成年住院患者进行了多阶段分层整群抽样，开展了“2020年中国营养基础数据”项目，以获取关于营养不良患病率的可靠数据，并探索相关危险因素。我们收集了参与者的社会人口学特征、体格检查和实验室检查结果。根据全球营养不良领导倡议（GLIM）标准定义营养不良。计算营养不良的标准化患病率，并使用逻辑回归分析检查与营养不良相关的因素。最终分析纳入了54,652名患有七种系统性疾病且完成所有调查问卷的个体。营养不良的总体患病率为12.5%，这意味着中国有760万成年住院患者存在营养不良。男性、60岁及以上人群、中西部地区居民、经济水平较低地区的人群以及教育水平较低者的营养不良患病率高于女性、60岁以下人群、东部地区居民、经济水平较高地区的人群以及教育水平较高者。疾病严重程度评分较高、患有传染病和肿瘤的患者比未患此类疾病的患者更易出现营养不良。性别、年龄、地区、经济水平、教育水平、疾病严重程度评分、传染病和肿瘤与营养不良独立相关。总之，中国成年住院患者中营养不良情况普遍，需要国家和医院层面的干预措施。这项调查为解决中国营养不良负担问题提供了多条途径。
