Abstract:

Objective To systematically evaluate malnutrition risk factors in diabetic foot patients through systematic review and inform evidence-based nutritional interventions. Methods A top-down search of the literature on risk factors for malnutrition in patients with diabetic foot was conducted according to the “6S” pyramid model，using a computerized decision-making system，clinical guideline websites，professional association websites and databases，with a timeframe of up to March 2025 for the search. Totally 2 researchers independently performed literature screening，quality assessment，and data extraction. Meta-analysis was conducted using Stata 18 software. Results Totally 23 studies with a total sample size of 5 068 cases were included. There were 10 influencing factors being extracted，including age（OR=2.709），BMI（MD=0.709），duration of diabetes mellitus（OR=2.589），glyco-sylated hemoglobin（OR=2.190），albumin（MD=0.578），hemoglobin（OR=2.948），infection（OR=1.816），C-reactive protein（OR=2.228），Wagner classification of diabetic foot（OR=4.620） and degree of self-care（OR=0.220）. The incidence of malnutrition in DFU patients who were assessed by the MNA-SF tool，the MNA tool and GLIM tool were 52.2%，70.2% and 41.4%. Conclusion The incidence of malnutrition in DFU patients is relatively high. Healthcare providers should continuously monitor the nutritional status of diabetic foot patients and implement personalized intervention plans to prevent malnutrition.

Key words: Diabetes Foot Ulcer, Malnutrition, Root Cause Analysis, Meta Analysis, Evidence-Based Nursing

摘要：

目的 系统评价糖尿病足患者营养不良的影响因素，为临床制订糖尿病足患者的营养干预提供循证依据。 方法 按照“6S”证据金字塔模型，自上而下检索计算机决策支持系统、临床指南网站、专业协会网站及数据库中关于糖尿病足溃疡患者并发营养不良危险因素有关的文献，检索时限为建库至2025年3月。由2名研究者独立进行文献筛选、质量评价和数据提取，采用Stata 18软件进行Meta分析。 结果 共纳入23篇研究，总样本量为5 068例。提取10种影响因素，包括年龄（OR=2.709）、BMI（MD=0.709）、糖尿病病程（OR=2.589）、糖化血红蛋白（OR=2.190）、白蛋白（MD=0.578）、血红蛋白（OR=2.948）、感染（OR=1.816）、C反应蛋白（OR=2.228）、糖尿病足Wagner分级（OR=4.620）和自理程度（OR=0.220）。使用微型营养评定简表、微营养评估表、全球营养领导人发起的营养不良倡议为评估工具的糖尿病足溃疡患者营养不良的发生率分别为52.2%、70.2%及41.4%。 结论 糖尿病足溃疡患者营养不良发生率相对较高，护理人员应持续监测糖尿病足溃疡患者的营养状况，实施个性化干预方案，以预防营养不良的发生。

关键词: 糖尿病足溃疡, 营养不良, 影响因素分析, Meta分析, 循证护理学