Nutritional risk in older diabetes patients tied to diabetic retinopathy

A low geriatric nutritional risk index (GNRI) score seems to worsen the risk of proliferative diabetic retinopathy (PDR) in older adults with type 2 diabetes, a recent study has found.

Researchers enrolled 1,359 patients who had undergone fundus examination between August 2006 and February 2014; DR was diagnosed by retinal ophthalmologists. Patient height, weight, and serum albumin levels were retrieved for GNRI calculation.

Dividing patients into tertiles of GNRI showed that the prevalence of DR was highest in the lowest category (55.2 percent) and dropped progressively through the second (39.1 percent) and third (26 percent) tertiles. Similarly, both proliferative and nonproliferative DR were higher in tertile 1 than in the other groups (p<0.001).

Multivariate logistic regression analysis found that being in tertile 1 (odds ratio [OR], 2.252, 95 percent confidence interval [CI], 1.08–4.823; p=0.033) and tertile 2 (OR, 2.602, 95 percent CI, 1.323–5.336; p=0.007) of GNRI scores increased the risk of PDR relative to tertile 3. Other PDR risk factors included old age, higher glycated haemoglobin, and proteinuria.

Of note, GNRI was not associated with nonproliferative DR, for which the risk factors only included longer disease duration, lower haemoglobin, higher glycated haemoglobin, and higher systolic blood pressure.

“To confirm our findings, longitudinal studies based on different races should be conducted to determine the association between nutrition status using GNRI and DR, and evaluate the effect of weight change on the development and progression of DR,” the researchers said.