Li Di, Han Jiaheng, Peng Ye, Yu Xi, Xiao Ying, Song Junxian, Liu Peng
Department of Clinical Nutrition, Peking University People's Hospital, Beijing 100044, China.
Faculty of Medicine, Macau University of Science and Technology, Taipa, Macao SAR 999078, China.
Nutrients. 2025 Aug 13;17(16):2624. doi: 10.3390/nu17162624.
Multiple studies demonstrated that nutritional risk and malnutrition were associated with prolonged hospitalization, extended rehabilitation duration, and increased mortality among patients with cardiovascular diseases (CVD). However, current research on dietary behaviors and nutritional status in hospitalized CVD patients remains insufficient. This study systematically evaluated the concordance between cardiology inpatients' and clinicians' subjective nutritional status assessments and objective energy and protein intake achievement rates, while comprehensively investigating the multidimensional associations among Nutritional Risk Screening 2002 (NRS 2002), Global Leadership Initiative on Malnutrition (GLIM), blood parameters, and dietary intake. This study adopted a cross-sectional design to investigate hospitalized patients in the department of cardiology. Dietary knowledge and behavior data were collected through questionnaires, and actual dietary intake was recorded. Nutritional risk assessment and malnutrition diagnosis were performed for all inpatients. Differences between subjective evaluations and actual intake were compared, and the correlation between blood biochemical indicators and nutritional status was analyzed. The study enrolled 618 valid cases, with male and female patients accounting for 67.48% and 32.52%, respectively. The patients' age was 61.89 ± 12.88 years. The NRS 2002 score was 3.01 ± 0.94, with 132 inpatients diagnosed with malnutrition according to GLIM criteria. Energy and protein intake reached only 63.09 ± 18.23% and 74.98 ± 22.86% of target values, respectively. NRS 2002 showed significant correlations with estimated glomerular filtration rate (eGFR), C-reactive protein (CRP), albumin (ALB), etc. No significant difference was found between physician and inpatient evaluations ( = 1.465, < 0.05). Both ordinal and multivariable logistic regression analyses demonstrated significant discrepancies between subjective assessments (inpatient perceptions and physician evaluations) and objective energy and protein intake levels ( < 0.05). Hospitalized cardiovascular patients commonly exhibited insufficient nutritional intake and limited dietary awareness. A mismatch existed between patient/clinician perceptions and objectively assessed nutritional intake. Subjective evaluations could not accurately reflect actual nutritional status, necessitating enhanced nutritional monitoring-including nutritional risk screening, biochemical testing, and dietary surveys-along with personalized interventions. Future efforts should enhance collaboration between clinicians and dietitians to improve patients' nutritional status and clinical prognosis.
多项研究表明，营养风险和营养不良与心血管疾病（CVD）患者住院时间延长、康复时间延长及死亡率增加有关。然而，目前关于住院CVD患者饮食行为和营养状况的研究仍然不足。本研究系统评估了心脏病住院患者与临床医生主观营养状况评估之间的一致性以及客观能量和蛋白质摄入达标率，同时全面调查了营养风险筛查2002（NRS 2002）、全球营养不良领导倡议（GLIM）、血液参数和饮食摄入之间的多维度关联。本研究采用横断面设计对心内科住院患者进行调查。通过问卷收集饮食知识和行为数据，并记录实际饮食摄入量。对所有住院患者进行营养风险评估和营养不良诊断。比较主观评估与实际摄入量之间的差异，并分析血液生化指标与营养状况之间的相关性。该研究纳入了618例有效病例，男性和女性患者分别占67.48%和32.52%。患者年龄为61.89±12.88岁。NRS 2002评分为3.01±0.94，根据GLIM标准，有132例住院患者被诊断为营养不良。能量和蛋白质摄入量分别仅达到目标值的63.09±18.23%和74.98±22.86%。NRS 2002与估计肾小球滤过率（eGFR）、C反应蛋白（CRP）、白蛋白（ALB）等显著相关。医生和患者评估之间未发现显著差异（ = 1.465，<0.05）。有序和多变量逻辑回归分析均表明主观评估（患者认知和医生评估）与客观能量和蛋白质摄入水平之间存在显著差异（<0.05）。住院心血管患者普遍存在营养摄入不足和饮食意识有限的情况。患者/临床医生认知与客观评估的营养摄入之间存在不匹配。主观评估无法准确反映实际营养状况，因此有必要加强营养监测——包括营养风险筛查、生化检测和饮食调查——以及个性化干预。未来应加强临床医生和营养师之间的合作，以改善患者的营养状况和临床预后。
