Introduction
Nutritional status is a critical factor in the progression of diabetes-related complications. This study investigates the sex differences in the impact of the Controlling Nutritional Status (CONUT) score on diabetic retinopathy (DR) using data from the National Health and Nutrition Examination Survey (NHANES) spanning 2003 to 2018.
Methods
The study utilized clinical data from NHANES, a survey conducted by the Centers for Disease Control and Prevention (CDC) to assess the health and nutritional status of adults and children in the United States. The analysis included 3,762 participants aged 20 or older, with data extracted from eight NHANES cycles. The association between CONUT scores and DR was evaluated using multivariate weighted logistic regression with restricted cubic splines (RCS). Subgroup analyses and interaction tests were conducted to assess the impact of CONUT scores on DR outcomes in male and female patients.
Results
The study found that a higher CONUT score was significantly associated with an increased risk of DR in women (OR = 1.88, 95% CI: 1.13–3.15), while no significant association was observed in men or the overall participant population. RCS regression indicated a linear positive correlation between CONUT score and DR risk in women (P-Nonlinear: 0.722). Subgroup analyses revealed that older female patients with diabetes, alcohol use, smoking history, hypertension, and hyperlipidemia had a significant positive association between higher CONUT scores and DR risk.
Discussion
Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder characterized by elevated blood glucose levels, leading to various complications, including DR, a leading cause of vision loss in adults. Approximately one-third of T2DM patients worldwide develop DR. Risk factors for DR include hyperglycemia, hypertension, and the duration of diabetes. Notably, sex differences may influence the incidence and complications of diabetes, with female patients more likely to experience vascular complications such as DR.
The study highlights the importance of personalized nutritional interventions for women at high risk for DR. The CONUT score, a nutritional screening tool, incorporates serum albumin, total lymphocyte count, and total cholesterol to provide a comprehensive evaluation of nutritional status and immune function. This multidimensional approach is valuable for identifying malnutrition risk and guiding clinical decision-making.
Conclusion
The study underscores the sex differences in the relationship between nutritional status and DR, emphasizing the need for sex-specific nutritional intervention strategies. High CONUT scores are significantly associated with DR prevalence in women, highlighting the critical role of nutritional status assessment in managing diabetic complications. These findings provide insights for developing personalized nutritional interventions for women with diabetes and pave the way for future research on nutritional strategies for preventing and treating DR.
The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.
The studies involving humans were approved by the Research Ethics Review Committee of the National Center for Health Statistics (NCHS). The studies were conducted in accordance with local legislation and institutional requirements. The participants provided their written informed consent to participate in this study.
Y-NH: Conceptualization, Writing – review & editing, Formal analysis, Writing – original draft. S-PL: Writing – review & editing. Y-XW: Writing – review & editing, Resources. Z-XX: Writing – review & editing, Conceptualization. LL: Supervision, Writing – review & editing.
The author(s) declare that no financial support was received for the research and/or publication of this article.
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
The author(s) declare that no Gen AI was used in the creation of this manuscript.
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The Supplementary Material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/fnut.2025.1597521/full#supplementary-material
🔗 **Fuente:** https://www.frontiersin.org/journals/nutrition/articles/10.3389/fnut.2025.1597521/full