ORIGINAL ARTICLE   

Minerva Endocrinology 2021 September;46(3):303-8

DOI: 10.23736/S2724-6507.20.03143-0

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: English

Sex difference in the association between malnutrition and hypoglycemia in hospitalized patients

Noa GUR ARIEH ¹, Henriett ADLER ², Israel KHANIMOV ³, Sami GIRYES ⁴, Meital DITCH ⁵, Noa FELNER BURG ², Mona BOAZ ⁶, Mordechai SHIMONOV ⁷, Eyal LEIBOVITZ ⁸ ✉

¹ Department of Family Medicine, Rabin Medical Center and Tel Aviv, Dan, and Eilat districts, Clalit Health Services, Tel Aviv, Israel; ² Department of Internal Medicine F, Wolfson Medical Center, Holon, Israel; ³ Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; ⁴ Department of Internal Medicine B, Rambam Healthcare Campus, Haifa, Israel; ⁵ Department of Internal Medicine A, Kaplan Medical Center, Rehovot, Israel; ⁶ Department of Nutrition Sciences, Ariel University, Ariel, Israel; ⁷ Department of Surgery A, Wolfson Medical Center, Holon, Israel; ⁸ Department of Internal Medicine A, Yoseftal Hospital, Eilat, Israel

BACKGROUND: The aim of this paper was to examine the difference between males and females regarding association between malnutrition risk and hypoglycemia through a sub-analysis of a cross-sectional study of newly admitted patients to internal medicine departments.
METHODS: Malnutrition risk, assessed with Nutritional Risk Screening 2002 (NRS2002), and serum albumin were measured upon admission. Logistic regression was applied to men and women separately, to test the effect of malnutrition and hypoalbuminemia on incidence of hypoglycemia.
RESULTS: Included were 1186 patients (50.4% males, 39.2% with positive NRS2002). Rate of positive NRS2002 was similar across sexes (36.5% vs. 41.2% in males and females respectively, P=0.204). Among females, NRS2002 was associated with higher incidence of hypoglycemia (9.5% vs. 2.4% in NRS2002 negative females, P<0.001). Among males, no such difference was noted (9.2% compared to 7.1% in NRS2002 positive and negative males respectively, P=0.520). The weight loss/decreased food intake criterion of the NRS2002 was significantly higher in the hypoglycemic group within females (P=0.03). Logistic regression showed that serum albumin was inversely associated with hypoglycemia in both females (OR 0.477, 95% CI 0.282-0.806, P=0.006) and males (OR 0.532, 95% CI 0.355-0.795, P=0.002). However, increased malnutrition risk was associated with hypoglycemia only among females (OR 2.007, 95% CI 1.058-3.809, P=0.033). Diabetes status was associated with hypoglycemia (OR 1.907, 95% CI 1.056-3.445, P=0.032) only in males; this association did not occur in females.
CONCLUSIONS: Malnutrition risk, as measured by the NRS2002, is associated with significantly increased incidence of hypoglycemia in women alone. Females who lose weight prior to hospitalization have an increased risk to develop hypoglycemia.

KEY WORDS: Malnutrition; Hypoglycemia; Sex