Controlling Nutritional Status (CONUT) score is a novel marker of type 2 diabetes mellitus and diabetic microvascular complications

ABSTRACT

Objectives

Type 2 diabetes mellitus (T2DM) and its microvascular complications are characterized by chronic inflammation. The Controlling Nutritional Status (CONUT) score is a tool used to assess nutritional status and is often associated indirectly with inflammatory processes. We aimed to compare the CONUT scores of T2DM patients with those of healthy volunteers and to compare T2DM patients with and without microvascular complications.

Methods

Patients diagnosed with T2DM and healthy volunteers (as controls) were included in the study. The CONUT score is calculated using the following formula: serum albumin score + total cholesterol score + total lymphocyte count score. CONUT scores of T2DM patients and healthy controls, as well as those of diabetics with and without microvascular complications, were compared.

Results

The CONUT scores of the T2DM and control groups were (1 [0–7]) and (0 [0–2]), respectively (p < 0.001). The sensitivity and specificity of the CONUT score (<1.5 threshold) in detecting T2DM were 43% and 90%, respectively (AUC: 0.67, p < 0.001, 95% CI: 0.64–0.71). Moreover, the CONUT score was an independent risk factor for T2DM (OR: 0.34, p < 0.001, 95% CI: 0.22–0.52). The CONUT score of T2DM patients with microvascular complications (2 [0–7]) was significantly higher than that of T2DM patients without microvascular complications (0 [0–4]) and control subjects (0 [0–2]) (p < 0.001). A CONUT score higher than 1.5 had 83% sensitivity and 92% specificity in detecting T2DM with microvascular complications (AUC: 0.91, p < 0.001, 95% CI: 0.89–0.93).

Conclusion

The CONUT score could be useful in detecting diabetic microvascular complications in clinical practice, as it is an inexpensive and easy-to-assess marker.

KEYWORDS:

• Type 2 diabetes mellitus
• microvascular complication
• CONUT score
• inflammation
• nutrition

Acknowledgments

The abstract of this paper has been presented in 22^nd annual European Congress of Internal Medicine in Istanbul, Turkey (March-2024).

Declaration of financial/other relationships

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

Gulali Aktas-design, methodology, statistical analyses, supervision, critical review of the manuscript; Tuba Taslamacioglu Duman – design, data curation, writing first draft; Burcin Atak Tel – design, data curation, literature research, writing first draft. All authors agree to the final form of the manuscript.

Data availability statement

The datasets used and analyzed during the current study are available from the corresponding author on reasonable request. The study was a retrospective review of the medical records.

Ethics statement

This study was carried out in line with research regulations, including approval by the Abant Izzet Baysal University ethical committee (approval number: 2023/240). This study is in accordance with the principles of the ‘World Medical Association Helsinki Declaration.’

Additional information

Funding

This paper was not funded.