Ran Qian, Zhao Xili, Xu Weiwei, Liu Li, Sun Hang, Luo Yunqiu
Department of Endocrinology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Second Clinical College, Chongqing Medical University, Chongqing, China.
Front Nutr. 2025 Jun 4;12:1596193. doi: 10.3389/fnut.2025.1596193. eCollection 2025.
Malnutrition has numerous adverse effects on the treatment and prognosis of diabetic foot (DF) patients, making it essential to determine the nutritional state to recognize malnutrition as early as possible. However, there is currently no acknowledged nutritional screening instrument for DF patients. This research aimed to identify the most appropriate nutritional assessment tool for this population.
We conducted a cross-sectional study with 247 DF patients. Nutritional assessments were performed using Nutritional Risk Screening 2002 (NRS2002) and the Mini-Nutritional Assessment short form (MNA-SF). The comparisons between scales were carried out based on the Global Leadership Initiative on Malnutrition (GLIM) criteria. The Cohen's kappa () and the area under the receiver operating characteristic curve (AUC) were analyzed to measure the diagnostic agreement of malnutrition among the screening tools and the GLIM criteria.
Ninety-eight patients (39.68%) were diagnosed with malnutrition according to the GLIM criteria. The detection rates of MNA-SF and NRS2002 were 48.18 and 42.51%, respectively. MNA-SF was better correlated with the GLIM criteria, with a higher Kappa value (0.665 vs. 0.535) and a greater area under the receiver operating characteristic curve (0.860 vs. 0.792) than NRS2002. Additionally, MNA-SF and NRS2002 had similar specificity (79.2 vs. 85.2%), but MNA-SF demonstrated higher sensitivity (89.8 vs. 67.4%).
This study is the first to describe the malnutrition diagnostic capacity of nutritional screening tools (MNA-SF and NRS2002) compared with the GLIM criteria. Our results indicate that the incidence of malnutrition is relatively high among DF patients, and the MNA-SF showed better sensitivity and correlation with the GLIM diagnostic criteria for malnutrition than NRS2002. Therefore, MNA-SF is more recommended for screening malnutrition in the DF population.
营养不良对糖尿病足（DF）患者的治疗及预后有诸多不利影响，因此尽早确定营养状况以识别营养不良至关重要。然而，目前尚无公认的针对DF患者的营养筛查工具。本研究旨在为该人群确定最合适的营养评估工具。
我们对247例DF患者进行了横断面研究。使用营养风险筛查2002（NRS2002）和微型营养评定简表（MNA-SF）进行营养评估。基于全球营养不良领导倡议（GLIM）标准对各量表进行比较。分析Cohen's kappa（κ）及受试者工作特征曲线下面积（AUC），以衡量筛查工具与GLIM标准之间营养不良诊断的一致性。
根据GLIM标准，98例患者（39.68%）被诊断为营养不良。MNA-SF和NRS2002的检出率分别为48.18%和42.51%。MNA-SF与GLIM标准的相关性更好，其Kappa值更高（0.665对0.535），受试者工作特征曲线下面积更大（0.860对0.792）。此外，MNA-SF和NRS2002的特异性相似（79.2对85.2%），但MNA-SF的敏感性更高（89.8对67.4%）。
本研究首次描述了营养筛查工具（MNA-SF和NRS2002）与GLIM标准相比的营养不良诊断能力。我们的结果表明，DF患者中营养不良的发生率相对较高，且MNA-SF在营养不良诊断方面比NRS2002表现出更好的敏感性及与GLIM诊断标准的相关性。因此，更推荐使用MNA-SF对DF人群进行营养不良筛查。
