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| Analysis of the Predictive Value of the Geriatric Nutritional Risk Index for Osteoporosis in Elderly Patients with Type 2 Diabetes Mellitus |
| SUN Silu, TAO Simin, XI Xiaoyan, et al |
| School of Nursing, Chengdu Medical College, Sichuan Chengdu 610083, China |
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Abstract Objective: To investigate the relationship between the Geriatric Nutrition Risk Index (GNRI) and bone mineral density in elderly patients with T2DM and the predictive value of GNRI for osteoporosis in elderly patients with type 2 diabetes. Methods: A total of 445 elderly patients with T2DM attending the First Affiliated Hospital of Chengdu Medical College from January 2019 to June 2022 were retrospectively selected, and the general data, bone mineral density data and relevant blood biochemical indexes of the study subjects were collected to calculate the geriatric nutritional risk index (GNRI) score. According to GNRI, they were divided into non-nutritional risk group (GNRI>98, n=283), low nutritional risk group (92≤GNRI≤98, n=95), and medium-high nutritional risk group (GNRI<92, n=67). Spearman correlation was used to analyze the correlation between BMD and the above indexes, and dichotomous logistic regression was used to analyze the relationship between GNRI and osteoporosis in elderly T2DM patients. The predictive value of GNRI for osteoporosis was analyzed using subject work characteristic (ROC) curves. Results: The age and prevalence of osteoporosis gradually increased in the non-nutrition risk group, low-nutrition risk group, and medium-high nutrition risk group, with statistically significant differences between the groups (P<0.001). Total protein (TP), serum albumin (ALB), serum calcium level, femoral neck BMD, lumbar spine BMD, and total hip BMD decreased sequentially in the non-nutrition risk group, low-nutrition risk group, and medium-high nutrition risk group, and the difference between the groups was statistically significant (P<0.05). spearman correlation results showed that GNRI was positively correlated with BMD at all sites (r = 0.211, 0.183, 0.180, P<0.001). The results of dichotomous logistic regression analysis showed that GNRI was an independent protective factor for the development of osteoporosis [OR=-0.155, 95% CI (0.753, 0.974), P<0.05]. The results of ROC curve analysis showed that GNRI had 43.43% sensitivity, 74.32% specificity and 17.76% Yordon index for the diagnosis of osteoporosis. The best cut-off value was 98.282. Conclusion: GNRI levels in elderly T2DM patients were positively correlated with BMD at all sites; GNRI is an independent protective factor for the development of osteoporosis and may also be a valid predictor of the development of osteoporosis in elderly T2DM patients.
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2023, Vol. 29 
