Sex differences in the impact of controlling nutritional status score on diabetic retinopathy: findings of 2003–2018 National Health and Nutrition Examination Survey

BackgroundNutritional status plays a crucial role in the progression of diabetes complications. This study assessed sex differences in Controlled Nutritional Status (CONUT) score and diabetic retinopathy (DR).MethodsClinical data between 2003 and 2018 were retrieved from the National Health Nutritio...

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Main Authors: Yu-Nan Han, Shui-Ping Li, Yong-Xiang Wang, Zui-Xuan Xiao, Lin Li
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-05-01
Series:Frontiers in Nutrition
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Online Access:https://www.frontiersin.org/articles/10.3389/fnut.2025.1597521/full
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author Yu-Nan Han
Shui-Ping Li
Yong-Xiang Wang
Zui-Xuan Xiao
Lin Li
author_facet Yu-Nan Han
Shui-Ping Li
Yong-Xiang Wang
Zui-Xuan Xiao
Lin Li
author_sort Yu-Nan Han
collection DOAJ
description BackgroundNutritional status plays a crucial role in the progression of diabetes complications. This study assessed sex differences in Controlled Nutritional Status (CONUT) score and diabetic retinopathy (DR).MethodsClinical data between 2003 and 2018 were retrieved from the National Health Nutritional Examination Survey (NHANES) database. The association of CONUT score with DR was analyzed by multivariate weighted logistic regression with restricted cubic splines (RCS). The impact of CONUT scores on DR outcomes in male and female patients was evaluated by subgroup analyses and interaction tests.ResultsA total of 3,762 participants were included in this study. After adjusting for all covariates, a higher CONUT score was positively associated with DR risk in women (OR = 1.88, 95% CI: 1.13–3.15), while no significant association between CONUT score and DR was observed in male participants and the overall participant population. In addition, RCS regression showed a linear positive correlation between CONUT score and DR risk in women (P-Nonlinear: 0.722). Subgroup analyses revealed a significant positive association of higher CONUT scores with DR risk in older female patients with diabetes, alcohol use, smoking history, hypertension, and hyperlipidemia.ConclusionThere is a sex difference in the link between higher CONUT scores and the prevalence of DR. Specifically, these findings highlight the importance of personalized nutritional intervention in women at high risk for DR.
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spelling doaj-art-c878b084b9374db5913aca27e0ea662c2025-08-20T02:25:26ZengFrontiers Media S.A.Frontiers in Nutrition2296-861X2025-05-011210.3389/fnut.2025.15975211597521Sex differences in the impact of controlling nutritional status score on diabetic retinopathy: findings of 2003–2018 National Health and Nutrition Examination SurveyYu-Nan Han0Shui-Ping Li1Yong-Xiang Wang2Zui-Xuan Xiao3Lin Li4Department of Endocrinology, The First Affiliated Hospital of Yangtze University, Jingzhou, Hubei, ChinaDepartment of Endocrinology, The First Affiliated Hospital of Yangtze University, Jingzhou, Hubei, ChinaDepartment of Medicine, Yangtze University, Jingzhou, Hubei, ChinaDepartment of Endocrinology, The First Affiliated Hospital of Yangtze University, Jingzhou, Hubei, ChinaDepartment of Endocrinology, The First Affiliated Hospital of Yangtze University, Jingzhou, Hubei, ChinaBackgroundNutritional status plays a crucial role in the progression of diabetes complications. This study assessed sex differences in Controlled Nutritional Status (CONUT) score and diabetic retinopathy (DR).MethodsClinical data between 2003 and 2018 were retrieved from the National Health Nutritional Examination Survey (NHANES) database. The association of CONUT score with DR was analyzed by multivariate weighted logistic regression with restricted cubic splines (RCS). The impact of CONUT scores on DR outcomes in male and female patients was evaluated by subgroup analyses and interaction tests.ResultsA total of 3,762 participants were included in this study. After adjusting for all covariates, a higher CONUT score was positively associated with DR risk in women (OR = 1.88, 95% CI: 1.13–3.15), while no significant association between CONUT score and DR was observed in male participants and the overall participant population. In addition, RCS regression showed a linear positive correlation between CONUT score and DR risk in women (P-Nonlinear: 0.722). Subgroup analyses revealed a significant positive association of higher CONUT scores with DR risk in older female patients with diabetes, alcohol use, smoking history, hypertension, and hyperlipidemia.ConclusionThere is a sex difference in the link between higher CONUT scores and the prevalence of DR. Specifically, these findings highlight the importance of personalized nutritional intervention in women at high risk for DR.https://www.frontiersin.org/articles/10.3389/fnut.2025.1597521/fullsex differencesCONUT scorediabetesdiabetic retinopathyNHANES
spellingShingle Yu-Nan Han
Shui-Ping Li
Yong-Xiang Wang
Zui-Xuan Xiao
Lin Li
Sex differences in the impact of controlling nutritional status score on diabetic retinopathy: findings of 2003–2018 National Health and Nutrition Examination Survey
Frontiers in Nutrition
sex differences
CONUT score
diabetes
diabetic retinopathy
NHANES
title Sex differences in the impact of controlling nutritional status score on diabetic retinopathy: findings of 2003–2018 National Health and Nutrition Examination Survey
title_full Sex differences in the impact of controlling nutritional status score on diabetic retinopathy: findings of 2003–2018 National Health and Nutrition Examination Survey
title_fullStr Sex differences in the impact of controlling nutritional status score on diabetic retinopathy: findings of 2003–2018 National Health and Nutrition Examination Survey
title_full_unstemmed Sex differences in the impact of controlling nutritional status score on diabetic retinopathy: findings of 2003–2018 National Health and Nutrition Examination Survey
title_short Sex differences in the impact of controlling nutritional status score on diabetic retinopathy: findings of 2003–2018 National Health and Nutrition Examination Survey
title_sort sex differences in the impact of controlling nutritional status score on diabetic retinopathy findings of 2003 2018 national health and nutrition examination survey
topic sex differences
CONUT score
diabetes
diabetic retinopathy
NHANES
url https://www.frontiersin.org/articles/10.3389/fnut.2025.1597521/full
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