Associations between Geriatric Nutrition Risk Index, bone mineral density and body composition in type 2 diabetes patients

Table 1 Comparison of baseline characteristics among type 2 diabetes mellitus patients stratified by tertiles of the Geriatric Nutritional Risk Index

Characteristics	Total (n = 689)	GNRI tertile 1 (n = 230)	GNRI tertile 2 (n = 230)	GNRI tertile 3 (n = 229)	F/H/χ2	P value
Women [n (%)]	295 (42.8)	109 (47.4)	96 (41.7)	90 (39.3)	3.065	0.080
Age (yr)	55.59 ± 10.88	58.02 ± 10.49	56.00 ± 10.84	52.74 ± 10.69	28.071	< 0.001
Height (cm)	166.89 ± 8.24	165.25 ± 7.88	167.10 ± 8.52	168.33 ± 8.06	16.410	< 0.001
Weight (kg)	70.00 (62.00-80.00)	62.00 (56.00-69.00)	71.00 (64.75-78.85)	80.00 (72.75-90.00)	16.636	< 0.001
Diabetes duration (yr)	7.33 ± 6.20	8.96 ± 6.42	7.58 ± 6.44	5.45 ± 5.15	38.741	< 0.001
BMI (kg/m2)	25.39 (23.23-27.78)	22.92 (21.31-24.49)	25.53 (24.20-26.93)	28.28 (26.62-30.47)	19.284	< 0.001
SBP (mmHg)	133.84 ± 15.34	132.96 ± 16.80	133.89 ± 15.98	134.67 ± 12.98	1.420	0.234
DBP (mmHg)	81.00 ± 9.88	79.44 ± 10.19	80.76 ± 9.50	82.79 ± 9.70	13.343	< 0.001
Hypertension [n (%)]	333 (48.3)	112 (48.7)	117 (50.9)	104 (45.4)	0.492	0.483
GNRI (score)	105.61 (99.64-112.01)	97.09 (93.02-99.66)	105.62 (103.73-107.68)	114.25 (112.01-119.37)	27.818	< 0.001
Glucose-lowering therapies [n (%)]
Lifestyle alone	121 (17.6)	31 (13.5)	36 (15.7)	54 (23.6)	8.071	0.004
Insulin treatments	248 (36.0)	102 (44.3)	89 (38.7)	57 (24.9)	18.817	< 0.001
Insulin secretagogues	222 (32.2)	83 (36.1)	78 (33.9)	61 (26.6)	4.681	0.030
Insulin sensitizers	79 (11.5)	25 (10.9)	28 (12.2)	26 (11.4)	0.027	0.870
Metformin	322 (46.7)	88 (38.3)	110 (47.8)	124 (54.1)	11.622	< 0.001
AGIs	105 (15.2)	23 (10.0)	33 (14.3)	49 (21.4)	11.519	< 0.001
DPP-4Is	57 (8.3)	18 (7.8)	23 (10.0)	16 (7.0)	0.105	0.745
SGLT-2Is	93 (13.5)	28 (12.2)	35 (15.2)	30 (13.1)	0.085	0.771
GLP-1RAs	41 (6.0)	3 (1.3)	14 (6.1)	24 (10.5)	17.240	< 0.001
Statins	122 (17.7)	37 (16.1)	45 (19.6)	40 (17.5)	0.151	0.698
Laboratory findings
HbA1c (%)	8.99 ± 1.85	9.50 ± 2.02	8.92 ± 1.63	8.53 ± 1.75	33.073	< 0.001
Albumin (g/L)	38.50 (36.20-41.30)	35.90 (33.88-37.63)	38.60 (37.00-40.60)	41.70 (39.45-44.00)	17.954	< 0.001
Cr (µmol/L)	58.51 ± 21.32	58.22 ± 25.22	57.85 ± 21.58	59.46 ± 16.26	0.386	0.535
UA (µmol/L)	312.68 ± 99.25	279.47 ± 103.09	314.02 ± 89.46	344.68 ± 94.19	53.222	< 0.001
TG (mmol/L)	1.89 (1.18-3.11)	1.46 (0.98-2.33)	1.81 (1.15-2.83)	2.38 (1.58-3.98)	7.626	< 0.001
TC (mmol/L)	4.41 ± 1.06	4.29 ± 1.01	4.33 ± 0.98	4.62 ± 1.15	10.890	0.001
HDL-C (mmol/L)	1.14 ± 0.27	1.15 ± 0.28	1.15 ± 0.25	1.10 ± 0.27	3.679	0.056
LDL-C (mmol/L)	2.81 ± 0.87	2.80 ± 0.88	2.80 ± 0.82	2.84 ± 0.91	0.309	0.578
TBil (µmol/L)	11.21 ± 4.71	10.25 ± 4.60	11.43 ± 4.68	11.95 ± 4.70	15.213	< 0.001
OS (ng/mL)	11.85 ± 3.99	12.06 ± 4.26	11.88 ± 3.89	11.60 ± 3.82	1.508	0.220
β-CTX (ng/mL)	0.45 ± 0.22	0.51 ± 0.25	0.44 ± 0.21	0.41 ± 0.19	25.645	< 0.001
TP1NP (ng/mL)	40.73 ± 14.53	41.00 ± 14.00	40.74 ± 14.66	40.45 ± 14.98	0.165	0.685
DXA parameters (g/cm2)
LS-BMD	0.97 ± 0.16	0.92 ± 0.14	0.99 ± 0.17	0.99 ± 0.15	22.118	< 0.001
FN-BMD	0.77 ± 0.12	0.73 ± 0.12	0.79 ± 0.13	0.81 ± 0.11	53.333	< 0.001
H-BMD	0.91 ± 0.13	0.85 ± 0.12	0.91 ± 0.13	0.95 ± 0.12	83.980	< 0.001
T-BMD	1.10 ± 0.12	1.07 ± 0.12	1.10 ± 0.12	1.12 ± 0.11	21.875	< 0.001
Body composition
Total body fat (%)	31.03 ± 6.56	29.03 ± 6.55	30.80 ± 5.83	33.26 ± 6.62	51.017	< 0.001
Android/gynoid ratio	1.31 ± 0.22	1.23 ± 0.22	1.33 ± 0.21	1.36 ± 0.20	49.682	< 0.001
Fat mass index (kg/m2)	7.53 (6.20-9.09)	6.33 (5.08-7.53)	7.54 (6.44-8.74)	8.91 (7.51-10.75)	13.010	< 0.001
Lean mass index (kg/m2)	16.95 (15.53-18.54)	15.66 (14.44-16.83)	17.11 (15.92-18.39)	18.60 (16.99-19.90)	14.055	< 0.001
ASMI (kg/m2)	7.09 ± 1.17	6.38 ± 0.91	7.09 ± 0.97	7.79 ± 1.1	218.066	< 0.001

BMI: Body mass index; SBP: Systolic/diastolic blood pressure; DBP: Diastolic blood pressure; GNRI: Geriatric nutritional risk index; AGIs: α-glucosidase inhibitors; DPP-4Is: Dipeptidyl peptidase-4 inhibitors; SGLT-2Is: Sodium-glucose cotransporter-2 inhibitors; GLP-1RAs: Glucagon-like peptide-1 receptor agonists; Cr: Creatinine; UA: Uric acid; TG: Triglyceride; TC: Total cholesterol; HDL-C: High-density lipoprotein cholesterol; LDL-C: Low-density lipoprotein cholesterol; TBil: Total bilirubin; OS: Osteocalcin; β-CTX: β-collagen special sequence; TP1NP: Total type I procollagen N-terminal extension peptide; DXA: Dual energy X-ray absorptiometry; LS-BMD: Lumbar spine (L1-L4) bone mineral density; FN-BMD: Femoral neck bone mineral density; H-BMD: Hip bone mineral density; T-BMD: Total (whole-body) bone mineral density; ASMI: Appendicular skeletal muscle index.