Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Korea.
Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea.
Nutrients. 2021 May 23;13(6):1776. doi: 10.3390/nu13061776.
It is not yet clear whether nutritional status is associated with post-stroke cognitive impairment (PSCI). We examined the geriatric nutritional risk index (GNRI) on the domain-specific cognitive outcomes 3 months after a stroke.
A total of 344 patients with acute ischemic stroke were included for the analysis. The GNRI was calculated as 1.489 × serum albumin (g/L) + 41.7 × admission weight (kg)/ideal body weight (kg) and was dichotomized according to the prespecified cut-off points for no risk and any risks. The primary outcome was PSCI, defined as having adjusted z-scores of less than -2 standard deviations in at least one cognitive domain: executive/activation, memory, visuospatial and language. Multiple logistic regression and linear regression analyses were performed to investigate the association between the GNRI and cognitive outcomes.
Seventy (20.3%) patients developed PSCI 3 months after a stroke. The mean GNRI was 106.1 ± 8.6, and 59 (17.2%) patients had low (<98) GNRI scores. A low GNRI was independently associated with the PSCI after adjusting for age, sex, education, initial stroke severity, stroke mechanism and left hemispheric lesion (odds ratio, 2.04; 95% confidence interval, 1.00-4.14). The GNRI scores were also significantly associated with the z-scores from the mini-mental status examination and the frontal domain (β = 0.04, -value = 0.03; β = 0.03, -value = 0.03, respectively).
A low GNRI was independently associated with the development of PSCI at 3 months after an ischemic stroke. The GNRI scores were specifically associated with the z-scores of the global cognition and frontal domain cognitive outcomes.
目前尚不清楚营养状况是否与卒中后认知障碍（PSCI）有关。我们研究了老年营养风险指数（GNRI）对卒中后 3 个月特定认知领域的影响。
共纳入 344 例急性缺血性卒中患者进行分析。GNRI 的计算方法为：血清白蛋白（g/L）×1.489+入院时体重（kg）/理想体重（kg）×41.7，并根据预先设定的无风险和任何风险的截断点进行二分。主要结局为 PSCI，定义为至少一个认知域的校正 z 评分低于-2 个标准差：执行/激活、记忆、视空间和语言。采用多因素逻辑回归和线性回归分析 GNRI 与认知结局的关系。
70 例（20.3%）患者在卒中后 3 个月发生 PSCI。GNRI 的平均值为 106.1±8.6，59 例（17.2%）患者的 GNRI 评分较低（<98）。在调整年龄、性别、教育程度、初始卒中严重程度、卒中机制和左侧大脑半球病变后，低 GNRI 与 PSCI 独立相关（比值比，2.04；95%置信区间，1.00-4.14）。GNRI 评分也与简易精神状态检查和额叶域的 z 评分显著相关（β=0.04，-值=0.03；β=0.03，-值=0.03）。
低 GNRI 与缺血性卒中后 3 个月 PSCI 的发生独立相关。GNRI 评分与总体认知和额叶域认知结局的 z 评分有特异性关联。
