高密度脂蛋白胆固醇水平与营养风险筛查-评估-干预之间的关系：一项多中心横断面研究。

Relationship between high-density lipoprotein cholesterol levels and nutritional risk screening-assessment-intervention: a multicenter cross-sectional study.

作者信息

Li Qian, Zhu Hong, Ma Xianghua, Zhao Yan

机构信息

Department of Clinical Nutrition, Suqian Hospital Affiliated to Xuzhou Medical University, Nanjing Drum Tower Hospital Group Suqian Hospital, Suqian, China.

Department of Clinical Nutrition, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.

出版信息

Front Nutr. 2025 Jun 18;12:1528068. doi: 10.3389/fnut.2025.1528068. eCollection 2025.

DOI:10.3389/fnut.2025.1528068

PMID:40607030

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12213356/

Abstract

BACKGROUND

Globally, there is limited literature exploring the relationship between nutritional risk screening, nutritional assessment, nutritional intervention, and HDL-C levels. This study analyzes the relationship between HDL-C levels, nutritional risk screening, assessment, and intervention among newly admitted patients in Jiangsu Province.

METHODS

Between October 2020 and June 2021, this study randomly selected 23 hospitals from 12 cities in Jiangsu Province using a stratified cluster sampling method. For nutritional assessment, the study used NRS2002 for risk screening.

RESULTS

4,190 patients were assessed, revealing a low HDL-C prevalence rate of 30.7%. The prevalence exhibited an "N" shaped distribution with age. The prevalence of low HDL-C among patients assessed at nutritional risk was 34.6%, 1.228 times higher than that of patients without nutritional risk. In terms of nutritional assessment, patients with constipation, severe infection, chronic kidney disease, fever, high CRP, and hypoalbuminemia significantly increased risks of low HDL-C by 1.432, 2.496, 1.543, 3.056, 1.794, and 2.703 times, respectively. Patients with a history of esophageal stricture, malignant tumors, and closed head injuries reduced the risks of low HDL-C by 60.9, 23.3, and 78.8%, respectively. Additionally, patients with nausea and vomiting, pancreatic insufficiency, severe infection, fever, and hypoalbuminemia decreased HDL-C levels by 0.156 mmol/L, 1.465 mmol/L, 0.403 mmol/L, 0.301 mmol/L, and 0.250 mmol/L, respectively. Regarding nutritional intervention, compared to patients who did not receive intervention, those receiving parenteral nutrition significantly lowered HDL-C levels at 1.014 mmol/L, with an increased risk of low HDL-C by 2.048 times. All s <0.05.

CONCLUSION

Nutritional risk, nausea and vomiting, constipation, pancreatic insufficiency, severe infection, chronic kidney disease, fever, high CRP, hypoalbuminemia, and receiving parenteral nutrition are associated with lower HDL-C levels in patients. A history of esophageal stricture, malignant tumors, and closed head injury is associated with higher HDL-C levels in patients.

摘要

背景

在全球范围内，探索营养风险筛查、营养评估、营养干预与高密度脂蛋白胆固醇（HDL-C）水平之间关系的文献有限。本研究分析了江苏省新入院患者的HDL-C水平与营养风险筛查、评估及干预之间的关系。

方法

2020年10月至2021年6月期间，本研究采用分层整群抽样方法从江苏省12个城市的23家医院中随机选取研究对象。对于营养评估，本研究使用营养风险筛查2002（NRS2002）进行风险筛查。

结果

共评估了4190例患者，HDL-C低患病率为30.7%。患病率随年龄呈“N”形分布。营养风险评估为有风险的患者中HDL-C低的患病率为34.6%，是无营养风险患者的1.228倍。在营养评估方面，便秘、严重感染、慢性肾脏病、发热、高C反应蛋白（CRP）和低白蛋白血症患者HDL-C低风险分别显著增加1.432倍、2.496倍、1.543倍、3.056倍、1.794倍和2.703倍。有食管狭窄、恶性肿瘤和闭合性颅脑损伤病史的患者HDL-C低风险分别降低60.9%、23.3%和78.8%。此外，恶心呕吐、胰腺功能不全、严重感染、发热和低白蛋白血症患者的HDL-C水平分别降低0.156 mmol/L、1.465 mmol/L、0.403 mmol/L、0.301 mmol/L和0.250 mmol/L。在营养干预方面，与未接受干预的患者相比，接受肠外营养的患者HDL-C水平显著降低1.014 mmol/L，HDL-C低风险增加2.048倍。所有P<0.05。