Analysis of the predictive value of the Geriatric Nutritional Risk Index for osteoporosis in elderly patients with T2DM: a single-center retrospective study

Background: Nutritional status is associated with muscle strength and bone mineral density, and malnutrition is recognized as a risk factor for osteoporosis and T2DM. Previous studies have demonstrated the relationship between nutritional assessment tools and BMD. However, few studies have reported the validity of three nutritional risk assessment tools in predicting osteoporosis in the elderly with T2DM. This study aimed to investigate the correlation between three nutritional assessment tools (GNRI, PNI, CONUT) and BMD and to compare their validity in predicting osteoporosis in type 2 diabetes mellitus in the elderly. Method: This retrospective study collected clinical data including general information, biochemical indicators, and bone densitometry from 525 elderly patients with T2DM calculated GNRI, PNI, and CONUT scores, and categorized the patients into osteoporotic and non-osteoporotic groups. The correlation between the three nutritional assessment tools and BMD was analyzed using Spearman partial correlation. Binary logistic regression analyzed the relationship between GNRI and osteoporosis. ROC curves were used to compare the validity of GNRI, PNI, and CONUT in predicting osteoporosis. Results: : The osteoporotic group was older and had lower LDL, femoral neck BMD, lumbar spine BMD, and total hip BMD compared with the nonosteoporotic group. Spearman's partial correlation showed a positive correlation between femoral neck BMD and lumbar spine BMD, but no correlation was observed between total hip BMD and GNRI. Logistic regression analyses showed no association between PNI, CONUT scores, and the development of osteoporosis. After adjusting for age, sex, smoking, alcohol consumption, BMI, ALB, Cr, UA, FBG, TG, and HDL, the correlation between GNRI and osteoporosis remained. ROC curve analysis showed that GNRI in combination with age and albumin had better predictive ability for osteoporosis than PNI and CONUT. Conclusion: GNRI levels were positively correlated with femoral neck BMD and lumbar spine BMD; GNRI was an independent protective factor against osteoporosis in elderly patients with T2DM, and the predictive ability of GNRI for osteoporosis in elderly patients with T2DM was better than that of PNI and CONUT scores.