Nutritional risk screening and influencial factor analysis in hospitalized patients with comorbidity of tuberculosis and diabetes mellitus

doi:10.3969/j.issn.1000-6621.2021.01.009

Abstract

Abstract:

Objective To analyze the nutritional risk and its influencial factors in patients with tuberculosis complicated with diabetes mellitus and provide evidence for early nutritional intervention. Methods Tuberculosis with diabetes mellitus inpatients admitted in the infectious disease prevention and control center of the fifth affiliated hospital of Sun Yat-sen University from April 1, 2018 to August 31, 2019 were enrolled. Clinical data was collected, including gender, age, complications, type of TB diagnosis, type of patients, mycobacterium tuberculosis detection, disease course, anti-tuberculosis treatment time, hospitalization days, score of nutritional risk screening 2002 (NRS 2002), hemoglobin (Hb), albumin (ALB), prealbumin (PAB), fasting blood sugar (FBS), glycosylated hemoglobin (GHB), neutrophil/lymphocyte ratio (NLR), prognosis of nutrition index (PNI) and weight. Multivariate logistic regression was used to analyze related factors of nutritional risk. Results According to the NRS-2002 score, 35 patients with scores ≥3 were included in the nutritional risk group, and 134 patients with scores <3 were included in the non-nutritional risk group, with an incidence of nutritional risk of 20.71% (35/169). Multivariate logistic regression analysis showed that disease course lasting over one month was a risk factor for the occurrence of nutritional risks (OR (95%CI)=6.003 (1.662,21.688)) while high blood albumin level was a protective factor (OR (95%CI)=0.876 (0.815,0.942)), the higher the albumin, the lower the incidence of nutritional risk. Conclusion The incidence of nutritional risk in patients with tuberculosis complicated with diabetes was 20.71%, associated with disease course and blood albumin. The incidence of nutritional risk for patients with disease course ≥1 month was significantly higher than those having <1 month disease courses, while blood albumin was negatively associated with the incidence of nutritional risk.

Key words: Tuberculosis, Diabetes mellitus, Comorbidity, Nutrition disorders, Nutritional risk screening, Factor analysis,statistical

LUO Xiao-qing, DUAN Si-yu, LIN Ming-yu, DENG Xun, LIU Bi-fen, LI Lian, TANG Hui-wen, DING Li. Nutritional risk screening and influencial factor analysis in hospitalized patients with comorbidity of tuberculosis and diabetes mellitus[J]. Chinese Journal of Antituberculosis, 2021, 43(1): 42-46. doi: 10.3969/j.issn.1000-6621.2021.01.009

Figures/Tables 2

因素	无营养风险组(134例)	有营养风险组(35例)	统计检验值	P值
性别[例数(构成比,%)]			χ²=0.938	0.333
男	106(79.10)	25(71.43)
女	28(20.90)	10(28.57)
年龄组(岁)[例数(构成比,%)]			χ²=2.332	0.506
20~	9(6.72)	2(5.72)
40~	57(42.54)	13(37.14)
60~	64(47.76)	17(48.57)
80~90	4(2.98)	3(8.57)
BMI[例数(构成比,%)]			χ²=55.899	0.000
<18.5	0(0.00)	13(37.14)
18.5~	93(69.40)	19(54.29)
≥24	41(30.60)	3(8.57)
结核类型[例数(构成比,%)]			χ²=0.245	0.881
肺结核	123(91.79)	33(94.28)
肺外结核	5(3.73)	1(2.86)
肺结核并发肺外结核	6(4.48)	1(2.86)
患者类型[例数(构成比,%)]			χ²=0.000	0.984
初治	107(79.85)	28(80.00)
复治	27(20.15)	7(20.00)
结核分枝杆菌检出情况[例数(构成比,%)]			χ²=0.018	0.895
菌阴	33(24.63)	9(25.71)
菌阳	101(75.37)	26(74.29)
并发症[例数(构成比,%)]			χ²=0.389	0.533
有	61(45.52)	18(51.43)
无	73(54.48)	17(48.57)
病程(T₁)[例数(构成比,%)]			χ²=20.262	0.000
T₁≤1个月	57(42.54)	3(8.57)
T₁>1个月	77(57.46)	32(91.43)
抗结核治疗时间(T₂))[例数(构成比,%)]			χ²=0.813	0.666
未进行抗结核治疗	73(54.48)	20(57.14)
0<T₂≤2个月	57(42.54)	13(37.14)
T₂>2个月	4(2.98)	2(5.72)
Hb[g/L,M(Q₁,Q₃)]	133.50(119.25,146.00)	119.00(105.25,127.00)	U=-3.838	0.000
ALB[g/L,M(Q₁,Q₃)]	40.45(35.83,43.05)	34.30(28.63,38.93)	U=-4.244	0.000
PAB(g/L, $x ˉ$ ±s)	187.01±32.42	127.78±39.76	t=4.051	0.000
FBS[mmol/L,M(Q₁,Q₃)]	7.45(6.20,10.50)	8.75(6.55,9.78)	U=-0.333	0.739
GHB [%,M(Q₁,Q₃)]	8.05(6.93,10.48)	7.30(6.48,9.73)	U=-0.217	0.828
NLR[M(Q₁,Q₃)]	2.98(2.45,4.35)	3.73(2.22,5.25)	U=-2.405	0.016
PNI[M(Q₁,Q₃)]	46.68(42.73,50.39)	40.98(35.39,47.45)	U=-4.215	0.000
体质量[kg,M(Q₁,Q₃)]	60.00(55.00,68.98)	57.15(48.75,68.50)	U=-4.032	0.000
平均BMI[M(Q₁,Q₃)]	22.34(20.30,24.00)	21.39(18.27,23.84)	U=-4.424	0.000
住院天数[d,M(Q₁,Q₃)]	8.00(6.00,12.00)	8.50(7.00,11.25)	U=-1.777	0.076

影响因素	β值	s $x ˉ$ 值	Wald χ²值	P值	OR(95%CI)值
病程	1.792	0.655	7.480	0.006	6.003(1.662~21.688)
白蛋白	-0.154	0.040	12.786	0.000	0.876(0.815~0.942)
常量	2.019	1.425	2.007	0.157	7.528

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