ArticleBMC endocrine disorders2026
Association between malnutrition risk and diabetic nephropathy in adult patients with type 2 diabetes: a cross-sectional study and mediation analysis.
Article in BMC endocrine disorders, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe role of nutritional status, particularly the risk of malnutrition as quantified by the Geriatric Nutritional Risk Index (GNRI), in the development of diabetic nephropathy (DN) among patients with type 2 diabetes mellitus (T2DM) remains to be fully elucidated. Thus, this study aimed to investigate the cross-sectional association between GNRI-assessed nutritional risk and DN and to explore the potential mediating role of inflammatory markers.
methodsA total of 675 hospitalized T2DM patients were enrolled. Multivariate logistic regression was used to determine whether GNRI is independently associated with DN. A restricted cubic spline (RCS) curve was used to visualize the association between GNRI and DN, and exploratory mediation analysis was conducted to assess the roles of systemic immune-inflammation index (SII) and neutrophil-to-lymphocyte ratio (NLR).
resultsOf the 675 T2DM patients, 190 (28.1%) were diagnosed with DN. Compared with individuals without DN, the GNRI score was significantly lower in the DN group (P < 0.001). Multivariate logistic regression analysis revealed that compared with the lowest tertile (T1) of GNRI, the highest tertile (T3) was significantly associated with a lower prevalence of DN (OR 0.53, 95%CI 0.31–0.89, P = 0.017). The RCS curve demonstrated a significant linear inverse association between higher GNRI scores and DN (P = 0.006). Mediation analysis suggested that SII and NLR statistically mediated 13.60% and 7.51% of the association between GNRI and DN, respectively.
conclusionIn this cross-sectional study, lower GNRI scores were independently associated with DN in T2DM patients, and systemic inflammation partially explained this association. GNRI may serve as a potential and readily available clinical marker for nutritional-inflammation risk screening in this population. CLINICAL TRIAL NUMBER: Not applicable.
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